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探讨房室结折返性心动过速 (AVNR)合并束支阻滞时心内电图特征及其机制。 6 0例AVNRT患者 ,男 2 3例、女 37例 ,年龄 39± 11岁。将病例分为 3组 :Ⅰ组合并左束支组滞 (CLBBB) ;Ⅱ组合并右束支阻滞 (CRBBB) ;Ⅲ组无束支阻滞。心内电生理测定心动过速的频率 (HR)、冠状窦口A波至V波的距离 (AVcs)、His束处A波到V波的距离 (AVH)。三组心动过速的心率分别为 171± 2 3,16 6± 19,170± 17次 /分 ,三组之间差异无显著性 (P >0 .0 5 ) ;Ⅰ组与Ⅱ、Ⅲ组AVcs、AVH 比较 ,差异有显著性 ( 81± 12msvs 46± 11ms,49± 9ms;5 6± 13msvs 5 1± 10ms、5 0± 10ms,P均 <0 .0 5 ) ;Ⅱ组与Ⅲ组之间AVcs、AVH 差异无显著性。结论 :AVNRT合并束支阻滞时心动过速的心率无明显变化 ;当合并CLBBB时 ,His束到心室的传导时间延长 ,导致冠状窦与His束处的A、V间距延长 ;合并CRBBB时无上述现象发生。
To explore the characteristics and mechanism of intracardiac electrocardiogram (ECG) in atrioventricular nodal reentrant tachycardia (AVNR) with bundle branch block. Sixty-three AVNRT patients, including 23 males and 37 females, were aged 39 ± 11 years. The cases were divided into three groups: Ⅰ group with left bundle branch block (CLBBB); Ⅱ group with right bundle branch block (CRBBB); Ⅲ group without bundle branch block. Cardiac electrophysiological measurement of tachycardia frequency (HR), coronary sinus A wave to V wave distance (AVcs), His beam bundle A wave to V wave distance (AVH). The heart rate of tachycardia in the three groups was 171 ± 23,166 ± 19,170 ± 17 beats / min, there was no significant difference between the three groups (P> 0.05) AVH, the difference was significant (81 ± 12msvs 46 ± 11ms, 49 ± 9ms; 5 6 ± 13msvs 5 1 ± 10ms, 5 0 ± 10ms, P <0.05); AVcs between group Ⅱ and group Ⅲ AVH difference was not significant. Conclusions: The heart rate of AVNRT combined with bundle branch block has no significant change. When CLBBB is combined, the conduction time of His bundle to the ventricle is prolonged, resulting in the prolongation of A and V distances between coronary sinus and His bundle. When combined with CRBBB The above phenomenon occurs.