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患者男性,20岁,平素身体健康,半年前因心悸就诊,经M型超声诊断为“二尖瓣脱垂”,心电图检查示非阵发性左房心动过速,频率90次/分。以后每月复查心电图均与初诊时心电图相同。近因心前区隐痛伴心悸又来复诊。体检:消瘦,心尖部可闻及收缩中期喀喇音和晚期杂音,心率约90次/分,心律不齐,余无特殊。心电图记录(附图)上行P_(Ⅰ、Ⅱ、aVF、V_6)倒置,P_(aVR、aVL、V_1)直立。下行Ⅱ导联P-R间期逐渐延长,R-R间期逐渐缩短,最后终止下传,呈典型文氏传导。同时可见3组文氏周期中,第1组和第3组为4:3传出阻滞结束文氏周期,第2组第4个QRS的T波上重叠一个倒P′,与前P间距小于左房心动过速的P-P间距,考虑可能为左房回波,再下传时受阻结束文氏周期。心电图诊断:非阵发性左房心动过速,Ⅱ°一型房室传导阻滞。
Male patient, 20 years old, usually healthy, six months ago due to palpitations, M-mode ultrasound diagnosis of “mitral valve prolapse”, ECG showed non-paroxysmal left atrial tachycardia, frequency 90 beats / min. After the monthly review of ECG are the same with the initial diagnosis of ECG. Nearly due to precordial pain and heart palpitations again referral. Physical examination: weight loss, apex can be heard and contractions midrange Kara tone and late murmur, heart rate about 90 beats / min, arrhythmia, I no special. ECG records (with photos) up P_ (Ⅰ, Ⅱ, aVF, V_6) inversion, P_ (aVR, aVL, V_1) upright. Downward Ⅱ lead P-R interval gradually extended, R-R interval gradually shortened, and finally stop the download, typical Venlo conduction. At the same time, we can see three groups of Wen’s cycle, the first group and the third group is 4: 3 out of the Blocking Wen’s cycle, the second group of the 4th QRS T wave overlap an inverted P ’, and the former P spacing Less than the left atrial tachycardia PP spacing, consider the left atrial echo may be, and then stop the transmission down Wen’s cycle. ECG diagnosis: non-paroxysmal left atrial tachycardia, Ⅱ ° atrioventricular block.