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患者男性,38岁,因心悸不适于1975年首次住院,当时心电图示房颤伴快速心室率(180次/分)及左束支传导阻滞(图1),查体及胸片检查无殊,经予100 WS 电击后转为窦性心律,其P-R 间期正常,但仍有左束支传导阻滞(图2)。于1982年因房颤复发而再次入院。24小时内给予1mg 地高辛,房颤心室率反而增快,最小R-R 间期为240ms,因考虑可能有房室旁道存在,故停用地高辛改腹奎尼丁400mg,每日2次,次日心电图检查已转为窦性心律。二维超声心动图检查示有三尖瓣下移畸形。
Male, 38, was unsuitable for first hospitalization in 1975 due to palpitations. Atrial fibrillation with atrial fibrillation with rapid ventricular rate (180 beats / min) and left bundle branch block (Figure 1) , After the 100 WS electric shock converted to sinus rhythm, the PR interval is normal, but there is still left bundle branch block (Figure 2). In 1982 due to recurrence of atrial fibrillation and re-admitted. 24 hours to give 1mg of digoxin, atrial fibrillation ventricular rate but increased faster, the minimum RR interval of 240ms, due to the consideration may be the presence of atrioventricular bypass, so disable digoxin to abdomen quinidine 400mg, daily 2 Times, the next day ECG has been converted to sinus rhythm. Two-dimensional echocardiography showed tricuspid regurgitation.