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患者男性,46岁,因冠心病、Ⅲ度 A-VB 晕厥安置 DDD 心脏起搏器。置入后曾见心房、心室顺序起搏,起搏及感知功能良好。2天后患者诉心悸。心电图Ⅰ导联(附图)的特点:(1)凡有起搏信号处,只见心室起搏而无心房起搏;(2)每4个心室搏动后,可见长间歇,共4组;(3)P波规则出现,心房率107次/min,比起搏器程序中预置的心房上限率(100次/min)为快。P-R间期渐次延长,分别为0.16、0.22、0.24及0.32s,组中第5个 P 波后,无起搏的心室波;长间距后 P 波又重新出现,P-R 间期又重新变短、再
A 46-year-old male patient with a DDD cardiac pacemaker was placed in a third-degree A-VB syncope due to coronary heart disease. After implantation, see the atria, ventricular pacing, pacing and sensory function is good. Two days later the patient complained of palpitation. ECG lead Ⅰ (with photos) Features: (1) Where there is pacing signal, only ventricular pacing was seen without atrial pacing; (2) after every four ventricular beats, can see a long interval, a total of 4 groups; (3) The P-wave rule appears with atrial rate of 107 beats / min faster than the preset upper limit of atrial pace (100 beats / min) in the pacemaker program. PR interval gradually extended, respectively, 0.16,0.22,0.24 and 0.32s, the group of P wave after the 5th, no pacing ventricular wave; P wave again after a long interval again, PR interval again shortened, again