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患者,女性,52岁。反复发作心动过速十余年,无心电图记录,体检、胸片、超声心动图检查未见异常。于1991年4月5日作食道电生理检查,调搏前心电图为窦性心律,B型预激征(图1,图1～4见封三)。检查过程中短阵快速刺激诱发室上速二次。心速频率187次/分,QRS波正常,PⅡ、Ⅲ、avF负向(图2)。食道导联见高尖P波,PR/RP>1,RP=100ms(图3)。符合顺向型房室折返性心动过速(OAVRT)。结合调搏前心电图,考虑为右侧kent′s束所致。诱发室上速均以短阵超速起搏终止。心房程序刺激固定S_1S=705ms,S_1S_2从550ms起以步长5ms反扫,示S_2R固定为200ms,均显示典型预激图形,当S_1S_2达325ms时S_2R突然延长达320ms,继后QRS正常。且出现连续四次的
Patient, female, 52 years old. Recurrent tachycardia more than ten years, no ECG records, physical examination, chest X-ray, echocardiography showed no abnormalities. On April 5, 1991 for esophageal electrophysiology, electrocardiogram before pacing sinus rhythm, B pre-excitation (Figure 1, Figure 1 to 4, see seal three). Check the process of short stimulation to stimulate the room speed twice. Heart rate 187 beats / min, QRS normal, P Ⅱ, Ⅲ, avF negative (Figure 2). Esophageal lead see high tip P wave, PR / RP> 1, RP = 100ms (Figure 3). In line with atrioventricular reentrant tachycardia (OAVRT). Combined with pre-pacing ECG, consider the right kent’s beam caused. Induction of supraventricular tachycardia were short-term overdrive pacing termination. Atrial program stimulus fixed S_1S = 705ms, S_1S_2 from 550ms step size 5ms anti-sweep, showing S_2R fixed 200ms, showed a typical pre-excitation graphics, when S_1S_2 325ms S_2R suddenly extended up to 320ms, followed by normal QRS. And appear four times in a row