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動悸,不整脈を訴えるが心電図上高度房室ブロックおよび心室早期興奮症候群を除外できる症例では,外来における心電図所見でも著明な異常を認めず,経過観察として外来通院している場合が多い。このような症例の中には頻拍発作を有する症例も含まれるが頻拍発作時,医療機関での心電図記録がない限り頻拍の種類も不明なことが多い。
また,短時間の発作性不整脈の場合にも外来診療上,症状と心電図所見とは一致せず,不整脈の種類および原因の追求されないままに薬剤投与されている症例もあるものと思われる。
Electrophysiological studies on 97 patients were done in order to define the latent dysfunction of atrioventricular conduction. All patients had electrocardiographic abnormalities of either first degree A-V block or occasional episodes of Wenckebach type A-V block or junctional rhythm, or had normal P-Q interval although complaining of palpitation or tachycardia. His bundle electrogram was done on 97 patients with rapid atrial pacing method and on 57 of those patients with atrial extrastimulus method. All electrophysiological data were analyzed with statistical test, and conclusively this dysfunction is defined when a patient has the next condition (1) and (2) or (3) condition described as follows.
(1) either electrophysiological abnormalities or cardiac symptoms described above.
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