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患者女性,61岁,风湿性心脏病、二尖瓣狭窄、心衰Ⅱ°。超声心动图及X线均提示左房大,符合二尖瓣狭窄诊断。图1P′_(Ⅰ、Ⅱ、Ⅲ、aVF、V_6)倒置,P′_(aVR、aVL)直立,P′_(V_1)呈先圆后尖形。房率167次/分,节律匀齐,P′-R间期0.28秒,且固定,房室传导2:1。图2为图1后两天描记的V_1导联,P′_(v_1)仍为先圆后尖形,房率150次/分,节律较匀齐。在2:1房室阻滞的基础上P-R逐渐延长,直至连续两个P波未下传。图中第1、2个文氏周期中的第1个P′-R间期(P_3′-R、P_(10)′-R)
Female patient, 61 years old, rheumatic heart disease, mitral stenosis, heart failure Ⅱ °. Echocardiography and X-ray showed a large left atrium, in line with mitral stenosis diagnosis. Fig.1 P ’_ (Ⅰ, Ⅱ, Ⅲ, aVF, V_6) upside down, P’_ (aVR, aVL) upright, P’_ (V_1) Room rate of 167 beats / min, uniform rhythm, P’-R interval 0.28 seconds, and fixed, atrioventricular conduction 2: 1. Figure 2 for the two days after the tracing of V_1 lead Figure 1, P ’_ (v_1) is still the first round after the tip-shaped, room rate 150 beats / min, rhythm more homogeneous. On the basis of 2: 1 atrioventricular block, P-R gradually extended until two consecutive P waves were not transmitted. The first P’-R interval (P_3’-R, P_ (10) ’- R)