摘要

Electrophysiologic studies with recordings of sinus node electrograms were performed in two patients with bradycardia-tachycardia syndrome. In both patients, the rest electrocardiogram showed apparent sinus bradycardia. Patient 1 had frequent paroxysms of atrial tachycardia with long pauses of up to 10 seconds; Patient 2 had paroxysmal atrial flutter and atrial pauses of up to 8 seconds. Multiple, repetitive, low frequency deflections, with a cycle length ranging from 730 to 960 ms in Case 1 and 570 to 750 ms in Case 2, suggestive of sinus node electrograms, were recorded at a critical area at the junction between the superior vena cava and the right atrium. These low frequency deflections had no relation to spontaneous junctional beats or the spontaneous atrial beats that showed high frequency deflections on the atrial electrogram. However, they could be suppressed by spontaneous or paced atrial beats. Pharmacologic interventions in Case 2 showed that the cycle length of the low frequency deflections shortened after administration of isoproterenol and did not change after propranolol or atropine. Thus, complete sinoatrial exit block with intact entrance conduction can occur in patients with bradycardia-tachycardia syndrome. Under such circumstances, the surface electrocardiographic manifestation of sinus bradycardia may not be of sinus origin.

译文

对两名心动过缓-心动过速综合征患者进行了电生理研究,记录了窦房结电图。在两个病人中,其余的心电图显示明显的窦性心动过缓。患者 1 有频繁的房性心动过速发作,长时间停顿长达 10 秒; 患者 2 有阵发性心房扑动,心房停顿长达 8 秒。多个,重复的,低频偏转,在案例 1 中的周期长度范围为 730 到 960 MS,在案例 2 中的周期长度范围为 570 到 750 MS,提示窦房结电图, 记录在上腔静脉和右心房之间交界处的关键区域。这些低频偏转与自发连接搏动或在心房电图中显示高频偏转的自发心房搏动无关。然而,它们可以被自发或节奏的心房跳动所抑制。案例 2 中的药物干预表明,服用异丙肾上腺素后低频偏转的周期长度缩短,而普萘洛尔或阿托品后没有变化。因此,在心动过缓-心动过速综合征患者中可发生完整的窦房出口阻滞,并具有完整的入口传导。在这种情况下,窦性心动过缓的表面心电图表现可能不是窦性起源。

sinoatrial block

心血管 窦房结 疾病
概述  :  

窦房结产生的冲动不能使心房除极或使心房除极延迟,称为窦房传导阻滞。心电图表现主要表现为窦性P波及相继的QRS波缺如。二度I型窦房阻滞表现为PP间期和相应的RR间期逐次缩短直至P-QRS波缺如出现长间期。二度II型窦房阻滞表现为显著延长的PP间期,其长度是窦性心律PP间期的两倍或数倍。二度窦房阻滞2: 1传导则在心电图上不能与窦性心动过缓相鉴别。一度窦房阻滞在心电图上不能诊断。三度窦房阻滞时P波完全消失,出现逸搏心律,心电图上亦难以诊断。病因和病理1、局灶性或弥漫性急性心肌炎性变,如急性风湿性

Sinoatrial [,sainəu'etriəl]
释义   adj. 窦房的
例句   A dimer or complex of two of the same molecule, usually a protein.
由两个相同的分子组成的二聚体或复合体,通常是蛋白质。

Block 英 [blɒk] 美 [blɑːk]
释义   n. 块;街区;大厦;障碍物
vt. 阻止;阻塞;限制;封盖
adj. 成批的,大块的;交通堵塞的
例句   Note that the resource adapter should not block in this method.
注意,资源适配器不应当阻塞在这个方法中。

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