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陈旧性心肌梗塞有时并发左束支阻滞(LBBB)型的室性心动过速。这类患者常伴有左室室壁瘤,经心表标测,室速来自室壁瘤边缘的室间隔部。而本文报道1例陈旧性心肌梗塞并发LBBB 型的室速,从起搏标测和室速的初始向量判断,提示室速起源于右室游离壁的流入道下部。患者女性,64岁。临床诊断:陈旧性下壁心肌梗塞,心动过速2个月入院。胸片检查提示轻度心脏扩大(心胸比率:0.58)。心电图示:窦性心律,Ⅱ、Ⅲ、aVF 导联异常Q 波,T_(v_3-v_6)异常(图1A)。自发单形性心动过速,呈LBBB 型,电轴左偏,频率171次/min(R-R 间距350ms)(图1B)。室性心动过速时给予静
Old myocardial infarction is sometimes associated with left bundle branch block (LBBB) type of ventricular tachycardia. Such patients often accompanied by left ventricular aneurysm, measured by the heart rate, ventricular tachycardia from the edge of the ventricular septum. In this paper, we report the ventricular tachyarrhythmias of a case of old myocardial infarction complicated with LBBB. From the initial vectors of pacemaker and ventricular tachycardia, it is suggested that the VT originated from the lower part of the inflow tract of right ventricular free wall. Patient female, 64 years old. Clinical diagnosis: old inferior myocardial infarction, tachycardia 2 months admission. Chest X-ray examination showed mild heart enlargement (cardiothoracic ratio: 0.58). ECG: sinus rhythm, Ⅱ, Ⅲ, aVF lead Q wave abnormalities, T_ (v_3-v_6) abnormalities (Figure 1A). Spontaneous monomorphic tachycardia, was LBBB type, left axis deviation, the frequency of 171 beats / min (R-R spacing of 350ms) (Figure 1B). Ventricular tachycardia given static