患者女性,49岁。因头昏伴反复晕厥6天,于1984年12月17日入院。既往有胸闷、心悸、气促史。临束诊断:1.病态窦房结综合征;2.室内三分支阻滞;3.阿-斯综合征。入院时描记的心电图(附图)示:窦性节律,P-P间距不等,为l.03—1.20s,心率50—58次/min,为窦性心动过缓及不齐。QRS有3种不同形态,(1)I导联呈qRs型,Ⅲ导联呈rS型,V_1呈rsR′型,时限0.13s,额面QRS电轴-72°,其前P-P间期固定,为0.16s,窦性P波下传,表现为完全性右束支阻滞合并左前分支阻滞;(2)V_1导联呈rS型,S波粗钝,时限0.12s,节律缓慢而又规则,室率37次/min,其前P与R无固定关系,此种QRS波为室性逸搏;(3)Qr型的室性早博。房室传导方式是下传心搏P-R间期固定,各组逐组增加1次下传心搏,固定连续3个窦性P波下传受阻,形成文氏型心室反应,变化是下传1个脱落3个,出现2 Patient female, 49 years old. Due to dizziness with recurrent syncope for 6 days, on December 17, 1984 admission. Past chest tightness, palpitations, history of shortness of breath. Probable diagnosis: 1. Sick sinus syndrome; 2. Three-room block; 3. As-Syndrome. ECG traced on admission (with photos): sinus rhythm, P-P spacing ranging from l.03-1.20s, heart rate 50-58 beats / min, sinus bradycardia and missing. QRS has three different forms, (1) I lead was qRs type, Ⅲ lead was rS type, V_1 rsR ’type, duration 0.13s, frontal plane QRS axis -72 °, the former PP interval fixed, For 0.16s, sinus P wave down, showed complete right bundle branch block combined with left anterior branch block; (2) V_1 lead was rS type, S wave rough, time 0.12s, slow and regular rhythm , Room rate 37 beats / min, before the P and R no fixed relationship, this QRS wave ventricular escape; (3) Qr-type ventricular premature beats. Atrioventricular conduction is down heart beat PR interval fixed, each group by one group down one heartbeat, fixed three consecutive sinus P wave down block, the formation of Venn-type ventricular response, the change is down 1 A 3 off, appeared 2