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患者男性,40岁,因发作性心悸、气促2年余,伴下肢浮肿加剧12天来诊。临床诊断。扩张型心肌病、心力衰竭Ⅱ度。入院后患者出现阵发性室上速共4次,先后应用多巴胺、阿拉明及异搏定静注后转为窦性心律,在第2次静注阿拉明5mg转为窦性心律后,出现A型WPW与窦房结内节奏点游走,均呈间歇性出现,持续1小肘后自行消失。此后几次阵发性室上速经药物转复后均未再出现。图1(见第103页,后同)Ⅲ导联的第3个P-QRS与aVF、V_1导联全部P-QRS均呈现典型的A型WPW。图2为Ⅱ导联,第2—4行是连续描记。第一行为患者入院后第1次心动过速静注阿拉明5mg后,从发作开始的心室率200次/分到逐渐减慢为176—166次/分,中问有1.88秒的心电活动暂停后再恢复窦性心律不齐(心率变动于83—107次/分之间)。第2行中P_(2-4、12-14),第3行中P_1及第4行中P_(2-4,0-12)的形态明显矮
Male patient, 40 years old, due to episodes of heart palpitations, shortness of breath more than 2 years, with lower extremity edema exacerbated 12 days to the clinic. clinical diagnosis. Dilated cardiomyopathy, heart failure Ⅱ degree. After admission, patients with paroxysmal supraventricular tachycardia a total of 4 times, has applied dopamine, alamin and verapamil intravenously into sinus rhythm, in the second intravenous injection of Alamin 5mg into sinus rhythm, there A-type WPW and sinus node rhythmicity walk, were intermittent, sustained for a small elbow disappear on their own. After several paroxysmal supraventricular tachycardia after drug relapse were not reappeared. The first P-QRS and the aVF of lead III and the whole P-QRS of lead V_1 all showed the typical type A WPW in Figure 1 (see page 103, the same). Figure 2 is the lead II, the first 2-4 lines are continuous tracing. The first line of patients admitted to hospital after the first tachycardia intravenous Alamin 5mg, from the onset of ventricular rate of 200 beats / min to gradually slow down to 176-166 beats / min, asked 1.88 seconds of ECG activity Suspended before resuming sinus arrhythmia (heart rate changes in the 83-107 beats / min). P_ (2-4,12-14) in row 2, P_1 in row 3 and P_ (2-4,0-12) in row 4 were significantly shorter