逸搏-夺获二联律伴左右束支交替性阻滞及双径路传导1例

Escape-captural beats in bigeminy with alternative right-left bundle branch block and dual pathways conduction:one case report

1病例资料 患者，男，52岁，因胸闷、心悸、乏力1个月，伴晕厥1次就诊。临床诊断：冠心病，晕厥原因待查。入院心电图（图1）系V1导联连续记录，窦性P波规律出现，部分P波传导受阻，其中1次受阻P波落在QRS波起始部或与之重叠而无法显现，频率约68次／min，房室传导比例为3：1。QRS波呈3种形态，奇数心搏前无相关P波，推迟出现，QRS波形态正常，为房室交接区逸搏，逸搏间期1．47～1．62S。

Summary A male patient in 52-year was on syncope attack. Clinical diagnosis showed CHD. Emergency ECG indicated high-degree AV block, AV junctional escape beats and ventricular capture form the bigeminy, ventriculra-capture appeared with alternative right left bundle branch block and conducted through dual pathways of AV node.