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通过对5例安置人工心脏起搏器患者的心室起搏电图现象分析,发现有如下特征:(1)当心室起搏出现逆行P波时,RP-间期长度有两种或两种以上,相邻两个RP-差值≥60ms;(2)RP-突然净增60ms或达到250ms(不作房室结内隐匿性折返解释);(3)RP-间期成倍增长,有时伴有心室回波;(4)紧随心室起搏QRS波后有两个P-波,应考虑为1:2室房传导,但需除外预激旁道参与逆传;(5)起搏源性室房传导中断后重新开始时,RP-往往较短。据此,作者提出通过推理分析可在体表心电图上作出起搏源性房室结双径(或多径)路传导的诊断。
Through the analysis of ventricular pacing electrocardiogram in 5 patients with artificial cardiac pacemaker, we found the following characteristics: (1) When retrograde P wave appears in ventricular pacing, there are two or more RP-intervals , Two adjacent RP-difference ≥60ms; (2) RP-sudden net increase of 60ms or up to 250ms (not for antrioventricular node occult reentry interpretation); (3) RP-interval doubling, sometimes accompanied by Ventricular echo; (4) immediately followed by ventricular pacing QRS wave has two P-wave, should be considered 1: 2 room conduction, but with the exception of the pre-excitation bypass to participate in retrograde; (5) pacing RP- tends to be shorter when room conduction is resumed after interruption. Accordingly, the authors propose that the diagnosis of pacing-induced AVN (or multipath) pathway conduction may be made on the body surface electrocardiogram by reasoning analysis.