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例1 男性37岁,既往无心脏病史,因突发心悸、心跳加快一周就诊。就诊前一直坚持司机工作。查体:血压14.6/10kPa(110/75mmHg),心界不大,心率188次/分、律齐。余无异常。血糖、血脂、X线胸片、彩色多普勒二维超声心动图(简称心脏B超)检查均正常。发作时心电图示:QRS波群宽大畸形、闻期0.12s,呈不典型的右束支传导阻滞(RBBB)图型,电轴左偏—95°。因考虑室上性心动过速伴室内差异性传导(简称室上速伴差传),先后给予ATP 20mg静脉注射二次、异搏定5mg静脉注射二次,均无效。后改用利多卡因100mg,在静脉注射过程中即转为窦性心律。复津后Ⅱ、Ⅲ、aVF、V_1～V_5导联出现ST段下移,T
Example 1 Male 37 years old, no prior history of heart disease, due to sudden heart palpitations, rapid heartbeat visits a week. Always insist on driver work before treatment. Physical examination: blood pressure 14.6 / 10kPa (110 / 75mmHg), heart is not, heart rate 188 beats / min, law Qi. I no exception. Blood glucose, blood lipids, X-ray, color Doppler two-dimensional echocardiography (referred to as heart B ultrasound) were normal. Episode electrocardiogram: QRS complex broad deformity, smell period 0.12s, showed atypical right bundle branch block (RBBB) pattern, the left axis deviation of -95 °. Due to the consideration of supraventricular tachycardia with indoors differential conduction (referred to as supraventricular tachycardia with differential), has given ATP 20mg intravenous injection, verapamil 5mg intravenous injection twice, were ineffective. After the switch to lidocaine 100mg, that is converted to sinus rhythm during the intravenous injection. After re-Ⅱ Ⅱ, Ⅲ, aVF, V_1 ~ V_5 lead ST segment down, T