房室伝導曲線よりみたDual A-V nodal pathwaysについて

Dual AV nodal pathways in AV conduction curves

　Paroxysmal supraventricular tachycardia （PSVT）の発生機序に関しては異所性興奮説^1）とReentry説^2,3）があるが最近の電気生理学的研究ではReentryがその主体をしめている。今回我々は房室結節でのReentryに最も重要な働きをするDual AV nodal pathways^4,5,6）の存在につき，房室伝導曲線^5,6）を中心とし，ヒス束心電図学的に若干の検討を加えたので報告する。

We studied the relation between AV conduction curves (A₁A₂-H₁H₂, A₂H₂) and dual AV nodal pathways by his bundle electrograms.

Method : Programmed atrial pacing with extrastimulus method and his bundle electrograms were performed.

Subjects : Studies were performed in 45 patients who were 11 with PSVT, 10 with sick sinus syndrome, 14 with lung cancer, 4 with ischemic heart disease, 1 with pancreatitis and 4 with other diseases.

Results : Twelve of these patients had discontinuous conduction curves suggestive of dual AV nodal pathways (D. P).