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1临床资料患者,男性,36岁。因心悸、头晕14小时,ECG诊断为阵发性室上性心动过速(PSVT)合并左束支传导阻滞(LBBB),静脉注射毛花甙C(西地兰)后心律未转复,转来我院。查体:血压10.5/6.5 kPa(78.8/48.8mmHg),脉搏细数。心界不大,心率180次/分,律齐,各瓣膜区无杂音。肝轻度增大。颈静脉中度充盈。ECG:QRS波宽大畸形,时限0.13s,同一导联的R′波形态基本一致,频率174次/分,R′R′间距相差0.03 s。V_1导联的ST-T形态不一,可能有P渡与其重叠,频率约107次/分。P波与QRS波无关,提示为房室分离(图
1 clinical data patients, men, 36 years old. ECG was diagnosed as PSVT with left bundle branch block (LBBB) due to heart palpitations and dizziness for 14 hours, no cardiac rhythm after intravenous injection of cedilanid C (cedilanid) Turn to our hospital. Physical examination: blood pressure 10.5 / 6.5 kPa (78.8 / 48.8mmHg), pulse breakdown. Heart, heart rate 180 beats / min, law Qi, the valve area without noise. Liver mild increase. Medium jugular filling. ECG: Large QRS wave deformity, time limit 0.13s, the same lead R ’wave morphology is basically the same, the frequency of 174 beats / min, R’R’ a difference of 0.03s. V-lead ST-T in different shapes, there may be P-overlapping with its frequency of about 107 beats / min. P wave and QRS wave has nothing to do, suggesting atrioventricular separation (Figure