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患者女性,48岁,风湿性心脏病,二尖瓣狭窄并关闭不全病史20年.因突发心悸、气促3h急诊入院.心电图(图略)示:频率273次/min的心房扑动.在2:1房室传导阻滞的基础上,下传心动的F-R间期由0.24s—0.34s逐渐延长,直到长R-R间距中3个F波连续受阻未下传而结束该文氏周期,周而复始,形成房室交界区的双层阻滞,其近端呈2:1传导,远端呈6:5文氏型传导.另可见ST_(1、v_5)压低、T(v_5)倒置.心电图诊断:房扑,A型交替性文氏周期,心肌劳损.
Patient female, 48 years old, rheumatic heart disease, mitral stenosis and closed incomplete history 20 years due to sudden heart palpitations, shortness of breath 3h emergency admission .Electrocardiogram (Figure omitted): atrial flutter frequency of 273 beats / min. On the basis of 2: 1 atrioventricular block, the FR interval of descending heartbeat gradually extended from 0.24s-0.34s until the 3 F-waves in the long RR interval were continuously blocked and did not pass to end the Wen’s cycle, Circumvacation of the atrioventricular junction formed a double block, with a 2: 1 conduction at the proximal end and a 6: 5 Wens conduction at the distal end. Also, ST_ (1, v_5) depression and T (v_5) inversion were seen. Diagnosis: atrial flutter, A-type alternating Venturi cycle, myocardial strain.