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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Wide complex tachycardia with a unique mode of termination: What is the mechanism?
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Wide complex tachycardia with a unique mode of termination: What is the mechanism?

机译：广泛的复杂性心动过速，具有独特的终止模式：其作用机理是什么？

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A 9-year-old patient who initially presented with syncope and a wide complex tachycardia was referred to our institution and underwent electrophysiology (EP) study. Echocar-diogram demonstrated a dilated left ventricle (left ventricular end-diastolic diameter 49 mm) with a left ventricular ejection fraction of 45%. At EP study, baseline rhythm was sinus at 74 beats per minute, atrio-His 97 ms, and His-ventricular (HV) 73 ms. Baseline QRS was 120 ms in duration and demonstrated a right bundle branch block pattern with rightward axis (Fig. 1). There was no evidence of dual atrioventricular (AV) node physiology or preexcitation with atrial extra stimulus testing. Of note, the HV interval prolonged to 90 ms with incremental atrial pacing, suggesting His Purkinje system disease. No ventriculoatrial (VA) conduction was observed at baseline; however, it was present with isoproterenol infusion and was midline and decremental.
机译：最初出现晕厥和广泛的复杂性心动过速的9岁患者被转诊到我们机构，并接受了电生理学（EP）研究。超声心动图显示左心室扩张（左心室舒张末期直径为49 mm），左心室射血分数为45％。在EP研究中，基线节律为窦性心律，每分钟74次，房室-His为97毫秒，心室（HV）为73毫秒。基线QRS持续时间为120毫秒，显示右轴为右束支传导阻滞（图1）。没有证据表明双房室（AV）节点生理或心房额外刺激试验会引起预激。值得注意的是，随着心房起搏的增加，HV间隔延长至90 ms，这表明他的Purkinje系统疾病。基线时未观察到心室（VA）传导;但是，它与异丙肾上腺素一起存在，呈中线递减状态。

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