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患者女,78岁。临床诊断为支气管炎,冠心病。入院心电图(见附图),aVF连续记录,P波有两种:①尖峰型,时间0.08S。电压0.20mv,P—R间期0.16S,P—P间距0.68～0.84S。②矮小型,时间0.04S,电压0.10mv,P—R间期与P—P间距与(1)相似。两种P波后均继以正常QRS波群。心电图诊断.①窦性心律。②间歇性不完全性房内传导阻滞(见图)。讨论:结间束首由James(1963)提出,包括前、中、后三束,前结间束有房间支分布于左房。结间束对P波形态有重要影响。如房间支传导阻碍,可以出现类似“二头瓣型P”。
Female patient, 78 years old. Clinical diagnosis of bronchitis, coronary heart disease. Admission electrocardiogram (see photo), aVF continuous recording, P wave has two: ① peak type, time 0.08S. Voltage 0.20mv, P-R interval 0.16S, P-P spacing 0.68 ~ 0.84S. ② dwarf, time 0.04S, voltage 0.10mv, P-R interval and P-P spacing and (1) similar. Both P wave followed by normal QRS complex. ECG diagnosis. ① Sinus rhythm. ② intermittent incomplete room conduction block (see photo). Discussion: The first between the bundles proposed by James (1963), including the front, middle and back three beams, the former between the bundles of rooms are distributed in the left atrium. The intercostal bundle has an important effect on the P wave morphology. Such as room branch conduction obstruction, can appear similar to the “two-flap type P”.