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患者男,75岁.1989年11月15日上楼时突感心悸、气短、头晕、黑蒙.继之晕倒、几分钟后意识恢复.但呕吐、出冷汗、持续约40分钟到某医院急诊.心电图示快速房颤,心室率180次/分,血压8.0/5.3kPa.予静脉注射药物(药名不详),2小时后转为窦律,血压升至16/10.7kPa.此后未服抗心律失常药物.心动过速也未出现.1990年11月16日午睡时突感胸闷、心慌,当即来我院就诊.心电图示阵发性室上速,心室率210次/分,血压5.3/2.7kPa,异搏定5mg静注.多巴胺静滴,50分钟后转为窦性心律,血压恢复至14.7/1O.7kPa.入院第3日又发作,予西地兰、多巴胺后转复为窦律,即以氨酰心安12.5mg/d长期口服维持窦性心律.1991年11月13日又因室上速发作再来我院,症状及治疗同前次,复律后口服异搏定120mg/d维持窦律出院.1992年11月5日患者怕室上速再出现而来院,根据周期性发作特点,给口服安定2.5mg、异搏定80mg,均1日3次,之后13～16日室上速即未出现.但因心动过速发作时室率可达180～210次/分伴血压下降,需较大剂量的静脉用药才能终止,而于1993年7月来我院接受经导管射频消蚀治疗.术前心电图检查正常,食道调搏示隐匿性预激综合征.在经心脏电生理检查确定隐性左后侧房室
Patient male, 75 years old. November 15, 1989 upstairs when the heart palpitations, shortness of breath, dizziness, dark, then fainted consciousness recovery after a few minutes.But vomiting, cold sweat, lasted about 40 minutes to a hospital Emergency ECG rapid atrial fibrillation, ventricular rate 180 beats / min, blood pressure 8.0 / 5.3kPa. To intravenous drug (drug name unknown), 2 hours later to sinus rhythm, blood pressure rose to 16 / 10.7kPa. Anti-arrhythmic drugs. Tachycardia did not appear. November 16, 1990 sudden nap when nap nap boring, palpitation, immediately came to our hospital .Virital electrocardiogram showed paroxysmal supraventricular tachycardia, ventricular rate of 210 beats / min, blood pressure 5.3 /2.7kPa, verapamil 5mg intravenous injection of dopamine, 50 minutes later converted to sinus rhythm, blood pressure returned to 14.7 / 1O.7kPa. On admission the third day of another episode, to cedilanid, dopamine and then returned to Sinus rhythm that avermectin 12.5mg / d long-term oral maintenance of sinus rhythm November 13, 1991 due to supraventricular tachycardia again in our hospital, symptoms and treatment with the previous, after cardioversion oral verapamil 120mg / d to maintain sinus rhythm was discharged .In November 5, 1992 patients were afraid of supraventricular tachycardia reappeared to hospital, according to the characteristics of cyclical seizures, orally taken to stabilize 2.5mg, verapamil 80mg, were on the 1st 3 times 13 to 16, supraventricular tachycardia that did not occur.But due to tachycardia episodes of up to 180 to 210 beats / min with blood pressure decreased, the need for larger doses of intravenous drug can be terminated, and in July 1993 I Hospital received RF catheter ablation treatment .Preoperative ECG examination, esophageal pustular syndrome showed preemptive excitation.In the electrophysiological examination to determine the recessive left posterior chamber