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患者男性,70岁。临床诊断为冠心病,心功能Ⅲ级,心电图诊断为完全性左束支传导阻滞(CLBBB),(图A)。心功能恢复后心率减慢呈间歇性LBBB,(图B)。住院期间,LBBB与正常传导多次交替出现,与心率有关,乃对患者作进一步观察。图C上下二条为连续描记,患者在心功能正常时作仰卧起坐10次,心率增快达112次/分,P-R间期0.16秒,R-R间期0.52秒,此时的窦性搏动(从R5开始)呈CLBBB,是由第三位相阻滞引起,又称快心率依赖型LBBB。图D箭头所示为患者作深吸气,其后出现明显窦性心律不齐,在一长R-R间期
Male patient, 70 years old. Clinical diagnosis of coronary heart disease, cardiac function grade Ⅲ, ECG diagnosis of complete left bundle branch block (CLBBB), (Figure A). Heart rate was reduced heart rate intermittent intermittent LBBB, (Figure B). During hospitalization, LBBB alternates with normal conduction several times, which is related to heart rate, which is used to further observe the patients. Figure C, the upper and lower two continuous tracing, patients with normal heart function when doing sit-ups 10 times, heart rate increased up to 112 beats / min, PR interval 0.16 seconds, RR interval 0.52 seconds, sinus beats at this time Start) was CLBBB, is caused by the third phase of block, also known as fast heart rate-dependent LBBB. Figure D arrow shows the patient as a deep inspiration, followed by significant sinus arrhythmia, in a long R-R interval