第23课 心房扑动伴交替性束支传导阻滞

Lesson Twenty-three Alterating bundle branch block during atrial flutter

一例患有阵发性心房颤动病史的68岁老年妇女施行了肺静脉隔离（术）。在肺静脉隔离后，于静脉输注异丙肾上腺素时，猝发式心房起搏诱发了周长为230ms的心房扑动，其房室传导易变而快速。在心动过速时可见交替型左束支传导阻滞（LBBB）和右束支传导阻滞（RBBB）（图1）。

A 68-year-old woman with a history of paroxysmal atrial fibrillation was referred for pulmonary vein isolation. After the pulmonary veins were isolated, burst atrial pacing during infusion of intravenous isoproterenol induced atrial flutter at a cycle length of 230 ms, with variable but rapid AV conduction. 1 An alternating pattern of left bundle branch block （LBBB） and right bundle branch block （RBBB） was observed during the tachycardia （Figure 1）.