患者,男,52岁。一年来易情结激动,劳累时常有短暂发作性心悸,伴胸闷,经休息可自行缓解。入院前三天上楼时突感心慌,胸部不适,气促,即送当地医院。检查:心率136次/分,心律绝对不规则,心电图示“房颤”。经静脉注射西地兰、口服地高辛等处理后,自觉症状反而加重,心率200次/分。次日复查心电图示“室速”,用利多卡因400mg 静脉滴注无效,即于1984年9月16日转来本院急诊。体检:一般情况尚好,血压100/70,心率速,无法数清,心律不齐。血清钾4.2mmoL/L。心电图示 R—R 间期不等,QRS 波增宽畸形,QRS 间期宽窄不一,室率约300次/分。最短的 R—R 间期为0.18秒。诊断:室速?预激综合征伴快室率房颤?(图1)。用利多卡因50mg 静脉推注,共三次, Patient, male, 52 years old. Over the past year, easy to complex excitement, fatigue often have transient onset of heart palpitations, with chest tightness, relieve themselves by rest. Upstairs three days before admission suddenly felt palpitation, chest discomfort, shortness of breath, that is, to the local hospital. Check: heart rate 136 beats / min, heart rate is absolutely irregular, ECG shows “atrial fibrillation.” After intravenous injection of cedilanid, oral digoxin and other treatment, but increased symptoms, heart rate 200 beats / min. The next day ECG review “VT”, intravenous infusion of lidocaine 400mg invalid, that is, September 16, 1984 transferred to our hospital emergency room. Physical examination: the general situation is good, blood pressure 100/70, heart rate, can not count the clear, arrhythmia. Serum potassium 4.2mmoL / L. ECG R-R interval ranging from QRS wave broadening deformity, QRS interval width varies, room rate of about 300 beats / min. The shortest R-R interval is 0.18 seconds. Diagnosis: VT? Wolff-Parkinson’s syndrome with fasting rate of atrial fibrillation? (Figure 1). Lidocaine 50mg intravenous injection, a total of three times,