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患者女,75岁,5年前因二度Ⅱ型房室传导阻滞植入起搏器,常规随访时心电图显示心室跟踪心房1∶1起搏,伪似三度房室传导阻滞。测试心房心室感知时发现自主心律为二度房室传导阻滞(2∶1下传),PR间期150ms。降低上限跟踪频率后,心室呈文氏型跟踪心房起搏,可见窦性P波下传时PR间期仍为150ms。提示心室起搏后存在室房隐匿性逆传,使房室结重整不应期,故产生连续的心室起搏。
Female, 75 years old, was implanted with a pacemaker for second-degree atrioventricular block 5 years ago. Ventricular follow-up ventricular 1: 1 pacing was performed at routine follow-up, with pseudo-third degree atrioventricular block. Test atrial ventricular perception found autonomic rhythm of second degree atrioventricular block (2: 1 down), PR interval of 150ms. Lowering the upper limit of tracking frequency, the ventricular was followed by atrial pacing Walker, showing sinus P wave downtime PR interval is still 150ms. Prompt ventricular pacing presence of hidden occlusion room, so that atrioventricular node should not recur, it produces a continuous ventricular pacing.