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本文报道预激合并房颤9例。临床症状可伴晕厥,休克、心衰。发作时心电图示心室率快,平均200次/分,V_1导联可见f波,多数QRS波>0.12秒,起始粗钝,少数正常。预激并房颤较多通过附加束,也可通过正常房室途径或二者同时激动心室,使QRS波呈多样性、易变性,酷似室速。发作时用延长附加束不应期的普鲁卡因胺等效果好,心得安等延长正常房室交界不应期,效果较差。洋地黄降低附加速有效不应期,可致室颤,对附加束下传的房颤应为禁忌。
This article reports the pre-excitation combined with atrial fibrillation in 9 cases. Clinical symptoms may be associated with syncope, shock, heart failure. The onset of ECG showed fast ventricular rate, an average of 200 beats / min, f-1 visible V-wave, the majority of QRS wave> 0.12 seconds, the initial blunt, a few normal. Pre-excitation and atrial fibrillation more by additional beam, but also through the normal atrioventricular pathway or both simultaneously excited ventricular QRS wave was diversity, variability, resembles VT. Epilepsy prolong the additional beam should not expired procaine amine and other effects of good, safe and so on to extend the normal atrioventricular junction refractory period, the effect is poor. Digitalis reduces the effective rate of additional effective refractory period, can cause ventricular fibrillation, the additional beam of the AF should be taboo.