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例1患者女、70岁,因反复晕厥入院。门诊行24h动态心电图检查V1导联连续记录(图1A)示:窦性心律,心率83bpm。下传心室QRS波呈左、右束支阻滞型,且不固定比例交替。同时PR间期亦呈长短交替,长短PR间期差>0.06s,其中右束支阻滞型QRS波前PR间期长,约0.16s,左束支阻滞型QRS波前PR间期短,约0.08s,两者形成十分固定的“匹配”关系。患者的24h动态心电图记录还出现较长时间的完全性右束支阻滞及完全性左束支阻滞,其前也分别呈现固定的长短两种PR间期(图略),上述情况可以排除室性期前收缩,考虑为房室结双径路,快径路经左束支下传心室,慢径路经右
Example 1 Female patient, 70 years old, admitted to hospital for recurrent syncope. Out-patient line 24h Holter examination V1 lead continuous recording (Figure 1A) shows: sinus rhythm, heart rate 83bpm. Downward ventricular QRS wave was left and right bundle branch block type, and not fixed ratio of alternating. At the same time PR interval also showed length alternation, the length of PR interval> 0.06s, including right bundle branch block QRS wavefront PR interval long, about 0.16s, left bundle branch block type QRS wavefront PR interval short , About 0.08s, the two form a very fixed “match ” relationship. Patients 24h Holter recording also showed a longer time of complete right bundle branch block and complete left bundle branch block, which also showed a fixed length before and after the two PR interval (Figure omitted) This can be ruled out Ventricular premature contraction, consider the dual atrioventricular node path, fast path through the left bundle branch download ventricle, slow path through the right