心脏传导的变异性裂隙现象

Variant gap phenomenon in A-V conduction

在连续３６１例患者心内电生理检查中，发现４例有心脏传导的裂隙现象。其特点表现为激动传导方向上远端平面相对不应期（ＲＲＰ）长，程序刺激中先出现传导延缓，随后近端平面也进入ＲＲＰ使传导变为延缓，激动经过近端平面延缓传导后，到达远端平面时其已脱离了ＲＲＰ，使已经在远端传导延缓的情况变为传导正常，与经典的裂隙现象相比，这种裂隙现象的发生机制，与心内电图的表现均有不同，暂定名为变异性裂隙现象。

n 361 consecutive patients 4 with variant gapphenomenon (VGP) underwent intracardiac electrophysiological studies. The premature atrial responseinitially delayed in Hispurkinje system (HPS) whichhad a long relative refractory period (RRP) , and H-Vinterval was prolonged. However, as atrial responseswere more premature, the atrioventricular node(AVN) showed RRP and slowed down the conduc-tion, that made HPS get rid of RRP before the re-sponse arriving. Thus the conduction resumed, and H-V interval became normal. It was different from theclassic gap phenomenon. We call it variant gap phe-nomenon.