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目的探讨预激综合征并发传导阻滞心电图PJ间期的变化。方法选经导管射频消融术(RFCA)治愈的显性预激综合征并发传导阻滞者10例,分为3组,即旁路(AP)位于束支阻滞(BBB)同侧组,旁路位于BBB异侧组及并发Ⅰ°房室阻滞(AVB)组。分别测量各组术前、术后的PJ间期并比较PJ间期变化。结果①6例旁路与BBB位于同侧的患者,术前PJ间期明显短于术后[(230±27)ms比(285±27)ms,P<0.01],但其中1例术前PJ间期为270ms(>260ms);②2例AP与BBB位于异侧的患者,术前PJ间期短于术后(P<0.01);③2例并发Ⅰ°AVB的患者,术前PJ间期明显短于术后PJ间期(P<0.01)。结论①预激综合征并发BBB时,PJ间期的变化取决于AP与正路的时差,AP与BBB的位置及AP距离心室最晚激动部位的远近,不能仅从AP的位置与BBB部位的关系来反映PJ的长短;②PJ间期的延长有可能为并发室内阻滞或AVB,宜进一步作食管心房调搏检查以明确诊断。
Objective To investigate the changes of PJ interval in pre-excitation syndrome complicated with conduction block electrocardiogram. Methods Ten cases of dominant WPW syndrome complicated with conduction block cured by RFCA were divided into three groups: the bypass (AP) was located in the ipsilateral group of the bundle branch block (BBB) Road located in the BBB hemiplegia and concurrent Ⅰ ° atrioventricular block (AVB) group. The preoperative and postoperative PJ intervals of each group were measured and the changes of PJ interval were compared. Results ① The preoperative PJ interval was significantly shorter in 6 patients with ipsilateral and BBB bypass than those in the postoperative [(230 ± 27) ms vs (285 ± 27) ms, P <0.01], but 1 patient had preoperative PJ The duration of preoperative PJ was shorter than that of postoperative (P <0.01); ②The 2 patients with Ⅰ ° AVB complicated with AVB had a significant preoperative PJ interval Shorter than postoperative PJ interval (P <0.01). Conclusions ①While the pre-excitation syndrome is complicated by BBB, the change of PJ interval depends on the time difference between AP and the right path, the location of AP and BBB, and the distance between AP and the latest ventricular ventricular activation region. The relationship between location of BB and BBB To reflect the length of PJ; ② prolongation of inter-PJ may be complicated by intra-office block or AVB, should further esophageal atrial pacing check to confirm the diagnosis.