房室接合部と心室に異所性中枢を有するDouble Parasystole

Double Parasystole-combined Atrioventricular Junctional and Ventricular Parasystole

　Double parasystoleはまれな不整脈である^1,2）。Dou—ble parasystoleのうち心室に二つの異所性中枢を有する例^3〜7），心房と心室に異所性中枢を有する例^8〜10），心房と房室接合部に異所性中枢を有する例^1）の報告は既にあるが，房室接合部と心室に異所性中枢を有するDoubleparasystoleの報告は見あたらない。我々は房室接合部と心室に異所性中枢を有するDouble parasystoleを経験したので報告する。我々が文献的に知る限りでは，その第1例である。

Double parasystole-combined atrioventricular junctional and ventricular parasystole was ob-served in a case of 48-year-old-man. The basic rhythm was sinus with normal QRS-T complex. Ectopic P' waves were inverted in II, III and aVF, and upright in aVR, with the P'-R interval of 0.08 sec. Wide, bizarre QRS complexes were also seen independently. These ectopic P' waves and wide bizarre QRS complexes appeared with varying coupling intervals had simple mathe-matical relationships in interectopic intervals. Atrial fusion between the sinus impulse and the atrioventricular junctional parasystolic one, and ventricular fusion between the atrioventricular junctional parasystolic impulse and the ventricular parasystolic one were observed.

This is the first case of the double parasystole-combined atrioventricular junctional and ven-tricular parasystole to our knowledge.