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征解35答案:一度房室阻滞、间歇性二度房室阻滞、双腔起搏器心电图伴心室保护性AAI起搏(即MVP功能)、起搏功能正常。诊断要点:本例心电图诊断难度较大,最终诊断为一度～二度房室阻滞,双腔起搏器功能正常。1.一度与间歇性二度房室阻滞:征解图中PR间期380m(sA),AAI起搏时pAV间期460ms,说明患者存在持续性一度房室阻滞。当PR间期>350ms时,常被诊断为PR间期过度延长,其能明显损害心脏舒张功能,使有效舒张期缩短。同时该患者还有间歇性二度房室阻滞,表现在部分心房起搏后伴QRS波的脱落(C、D)。
Sign solution 35 answer: once atrioventricular block, intermittent second degree atrioventricular block, dual chamber pacemaker ECG with ventricular protective AAI pacing (MVP function), pacing normal. Diagnostic points: This case of ECG diagnosis is more difficult, the final diagnosis of a degree ~ second degree atrioventricular block, double-chamber pacemaker function is normal. 1. Once and intermittent second degree atrioventricular block: Sign in the map PR interval 380m (sA), AAI pacing 460ms pacing, indicating the existence of persistent persistent atrioventricular block. When the PR interval> 350ms, often diagnosed as prolonged PR interval, which can significantly damage the diastolic function, the effective diastolic shortening. At the same time, the patient had intermittent second-degree atrioventricular blockade, which was manifested with shedding of QRS waves after some atrial pacing (C, D).