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本文报告了3例室性早搏R波落在P波上(RonP现象)引起室性心动过速。并结合文献复习,讨论了RonP现象予告室速或室颤的价值。认为RonP现象对予告室速或室颤比RonT现象敏感,有其特殊的价值。值得临床工作者重视。本文并对其机理进行了探讨。认为缺血的心肌或病变的心肌其易损期扩大到心动周期的大部分,故RonP可以激发室速或室颤,特别是舒张晚期的早搏则能够出现传导减慢及单向阻滞易产生持续折返,从而可以解释为什么RonP现象引起室速或室颤高于RonT现象。
We report three cases of ventricular premature beats R-wave in the P wave (RonP phenomenon) caused by ventricular tachycardia. Combined with the literature review, discussed the value of RonP ventricular tachycardia or ventricular fibrillation. It is of special value to think that the RonP phenomenon is more sensitive to RonT than premature ventricular tachycardia or ventricular fibrillation. It is worth to clinicians. This article also discusses its mechanism. It is thought that ischemic myocardium or diseased myocardium expands its vulnerability to most of the cardiac cycle, so RonP can stimulate ventricular tachycardia or ventricular fibrillation. Especially in advanced diastolic premature beats, conduction slowdown and unidirectional block are easy to occur Continued reentry, which can explain why the phenomenon of RonP caused by ventricular tachycardia or ventricular fibrillation than the RonT phenomenon.