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临床资料与心电图分析患者男性,59岁。临床诊断:男子乳房发育症。既往心电图检查无预激综合征。附图上、中行为1989年4月26日记录的V_1及食管导联,示窦P顺序出现,P-R间期固定为0.14秒,后继QRS波群正常,P-J时间0.22秒,其间可见提早出现的宽大畸形的QRS波群,主波与T波方向相反,时间0.13秒,其前无P′波,其后可见窦P与之干扰分离,R-R′间期固定为0.42秒,每间隔3个窦搏后出现一次,提示为折返型室性早搏四联律。然而值得注意的是室性早搏后第一个赛搏的P-R间期均缩短为0.08秒,后继ORS波增宽畸形达0.15秒,起始部有δ波,于V_1导联向下,食管、V_4～V_5导联向上(V_4～V_5导联图未附上)P-J时间0.22秒,R′-R间期不等为0.80～0.90秒,示B型预激综合征。附图下行为经食管心房程序电刺激检查,示随S_1S_2缩短,S_2V_2渐延长,V_2波时间、形态正常,无δ波,但V_2后第一个恢复的窦性心搏仍为B型顶激综合征。
Clinical data and ECG analysis of patients male, 59 years old. Clinical diagnosis: male breast development. Previous ECG without Wolff-Parkinson’s syndrome. In the accompanying figure, B-line recorded V_1 and esophageal lead, sinusoid P appeared in sequence, PR interval was fixed at 0.14 second, subsequent QRS complex was normal, PJ time was 0.22 seconds, during which early visible Large deformity QRS complex, the main wave and the T wave in the opposite direction, the time of 0.13 seconds, no P ’wave before, and then see the sinus P and interference separation, RR’ interval fixed at 0.42 seconds, every interval of three sinus After the stroke occurs once, suggesting that reentrant ventricular premature beat quadruple rhythm. However, it is noteworthy that the PR interval of the first race after premature ventricular contraction is shortened to 0.08 seconds, the successor ORS wave broadening deformity of 0.15 seconds, the beginning of the delta wave, V_1 leads down, the esophagus, V_4 ~ V_5 leads up (V_4 ~ V_5 leads are not attached) PJ 0.22 seconds, R’-R interval ranging from 0.80 to 0.90 seconds, showing the B-WPW syndrome. In the lower part of the figure, the esophageal atrial appendage electrical stimulation test showed that with S_1S_2 shortening, S_2V_2 gradually extended, V_2 wave time, normal morphology, no δ wave, but the first recovered after V_2 sinus heartbeat is still type B top-stimulating syndrome .