症例 交代性脚ブロックの1例
交代性脚ブロックの1 例を経験したのでヒス束心電図所見を中心に報告する.71歳女,主訴は失神発作.心電図所見:1)1:1房室伝導,右脚ブロック,PQ 0.18秒,2)2:1房室伝導,右脚ブロック,PQ 0.18秒の時と0.29秒の時の2通り,3)2:1房室伝導,左脚ブロック,PQ 0.18秒,4)完全房室ブロック,左脚ブロック型心室補充収縮(33/分)の他,5)2:1房室伝導で右脚ブロック,左脚ブロック,補充収縮が交代性に出現する記録も認めた.その際,右脚ブロック心拍はPQ 0.25秒,左脚ブロック心拍はPQ 0.19秒であった.ヒス束心電図所見:2:1房室伝導,左脚ブロックの時,PA20,A...
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| Published in | 心臓 Vol. 14; no. 4; pp. 546 - 552 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
公益財団法人 日本心臓財団
1982
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0586-4488 2186-3016 |
| DOI | 10.11281/shinzo1969.14.4_546 |
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| Abstract | 交代性脚ブロックの1 例を経験したのでヒス束心電図所見を中心に報告する.71歳女,主訴は失神発作.心電図所見:1)1:1房室伝導,右脚ブロック,PQ 0.18秒,2)2:1房室伝導,右脚ブロック,PQ 0.18秒の時と0.29秒の時の2通り,3)2:1房室伝導,左脚ブロック,PQ 0.18秒,4)完全房室ブロック,左脚ブロック型心室補充収縮(33/分)の他,5)2:1房室伝導で右脚ブロック,左脚ブロック,補充収縮が交代性に出現する記録も認めた.その際,右脚ブロック心拍はPQ 0.25秒,左脚ブロック心拍はPQ 0.19秒であった.ヒス束心電図所見:2:1房室伝導,左脚ブロックの時,PA20,AH100,HV70msecでHVブロックであった.2:1房室伝導,右脚ブロックの時,PA20,AH100,HV130msecでHVブロックであった.交代性脚ブロックの時,右脚ブロック心拍はPA20,AH100,HV70msecで,左脚ブロック心拍はPA20,AHI00,HV130msecでHVブロックであった.以上よりブロック部位局在につき考察した. |
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| AbstractList | 交代性脚ブロックの1 例を経験したのでヒス束心電図所見を中心に報告する.71歳女,主訴は失神発作.心電図所見:1)1:1房室伝導,右脚ブロック,PQ 0.18秒,2)2:1房室伝導,右脚ブロック,PQ 0.18秒の時と0.29秒の時の2通り,3)2:1房室伝導,左脚ブロック,PQ 0.18秒,4)完全房室ブロック,左脚ブロック型心室補充収縮(33/分)の他,5)2:1房室伝導で右脚ブロック,左脚ブロック,補充収縮が交代性に出現する記録も認めた.その際,右脚ブロック心拍はPQ 0.25秒,左脚ブロック心拍はPQ 0.19秒であった.ヒス束心電図所見:2:1房室伝導,左脚ブロックの時,PA20,AH100,HV70msecでHVブロックであった.2:1房室伝導,右脚ブロックの時,PA20,AH100,HV130msecでHVブロックであった.交代性脚ブロックの時,右脚ブロック心拍はPA20,AH100,HV70msecで,左脚ブロック心拍はPA20,AHI00,HV130msecでHVブロックであった.以上よりブロック部位局在につき考察した. |
| Author | 渡部, 高久 川原, 孝司 加藤, 孝和 前田, 知行 池田, 識道 佐々木, 嘉彦 |
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| References | 6) Rosenbaum, M. B., Elizari, M. V., Lazzari, J. O., Nau, G. J., Halpern, M. S. and Levi, R. J.: The differential electrocardiographic manifestations of hemiblocks, bilateral bundle branch block and trifascicularblocks. in Advances inelectrocardiography. ed. bySchlant, R. C. and Hurst, J. W. New York and London. Grune & Stratton, 1972. p. 145. 15) Lenegre, J.: Etiology and pathology of bilateral bundle branch block in relation to complete heart block. Progr. Cardiovas. Dis., 6: 409, 1964. 1) Yater, W. M., Cornell, V. H. and Claytor, T.: Auriculoventricular heart block due to bilateral bundle branch lesions. Arch. Intern. Med., 57: 132, 1936. 11)Iannone, L. A., Glasser, S. P. and MaCarty, R. J.: His bundle electrogram in trifasciculardisease: Report of a case studied with His bundle electrograms. J. Electrocardiology, 8: 269, 1975. 7)Pick. A. and Langendorf, R.: Atrioventricular and Intraventricularblock. in Interpretation of complex arrhythmias. Philadelphia. Lea&Febiger 1979. p. 300. 13) Narula, O. S.: Alternating Bundle branchbrock, in CardiacArrhythmias: Electrophysiology, diagnosis and management. Baltimore, Williams & Wilkins. 1979. p. 128. 14) Schamroth, L.: Bilateral bundle branch block. in the Disorders of Cardiac rhythm. Chap. 36, Oxford & Edinburgh, Blackwell ScientificPubl., 1971. p. 181. 8) Chung, E. K.: Intraventricular conduction disturbances. Chap. 7 and atrioventricular conduction disturbances. Chap. 8, in Principles of cardiac arrhythmias. Baltimore. William & Wilkins, 1977, p. 284, 334. 2) Rosenbaum, M. B. and Lepeschkin, E.: Bilateral bundle branch block. Am. Heart J., 50: 38, 1955. 3) Grieco, M. H., Schwartz, M. J. and Childs, E. P.: True bilateral bundle branch block. Am. J. Cardiol., 11: 666, 1963. 4) Lepeschkin, E.: The electrocardiographicdiagnosi of bilateral bundle branch block in relation to heart block. Progr. Cardiovas. Dis., 6: 409, 1964. 9) Ranganathan, N., Dhurandhar, R., Philips, J. H. and Wigle, E. D.: His bundle electrogram in bundle-branch block. Circulation, 45: 282, 1972. 10) Wu, D., Denes, P., Dhingra, R. C., Amat-Y-Leon, F., Wyndham, C. R. Chuquimia, R. and Rosen, K. M.: Electrophysiological and clinical observations in patients with alternating bundle branch block. Circulation, 53: 456, 1976. 12) Josephson, M. E. and Seides, S. F.: Clinical cardiac electrophysiology. Techniques and Interpretations. Philadelphia. Lea & Febiger, 1979. p. 103. 5) Schloff, L. D., Adler, L., Donoso, E. and Friedberg, C. K.: Bilateral bundle branch block. Clinical and electrocardiographic aspects. Circulation, 35: 790, 1967. 16)三羽啓夫, 三浦克也, 岩井雄可小林正明, 熊谷悦子, 志場正光: 通常12誘導心電図でほぼ診断し得たDual AV nodal pathways の電気生理学的検討. 心臓, 13: 183, 1981. |
| References_xml | – reference: 9) Ranganathan, N., Dhurandhar, R., Philips, J. H. and Wigle, E. D.: His bundle electrogram in bundle-branch block. Circulation, 45: 282, 1972. – reference: 4) Lepeschkin, E.: The electrocardiographicdiagnosi of bilateral bundle branch block in relation to heart block. Progr. Cardiovas. Dis., 6: 409, 1964. – reference: 5) Schloff, L. D., Adler, L., Donoso, E. and Friedberg, C. K.: Bilateral bundle branch block. Clinical and electrocardiographic aspects. Circulation, 35: 790, 1967. – reference: 10) Wu, D., Denes, P., Dhingra, R. C., Amat-Y-Leon, F., Wyndham, C. R. Chuquimia, R. and Rosen, K. M.: Electrophysiological and clinical observations in patients with alternating bundle branch block. Circulation, 53: 456, 1976. – reference: 12) Josephson, M. E. and Seides, S. F.: Clinical cardiac electrophysiology. Techniques and Interpretations. Philadelphia. Lea & Febiger, 1979. p. 103. – reference: 8) Chung, E. K.: Intraventricular conduction disturbances. Chap. 7 and atrioventricular conduction disturbances. Chap. 8, in Principles of cardiac arrhythmias. Baltimore. William & Wilkins, 1977, p. 284, 334. – reference: 1) Yater, W. M., Cornell, V. H. and Claytor, T.: Auriculoventricular heart block due to bilateral bundle branch lesions. Arch. Intern. Med., 57: 132, 1936. – reference: 2) Rosenbaum, M. B. and Lepeschkin, E.: Bilateral bundle branch block. Am. Heart J., 50: 38, 1955. – reference: 15) Lenegre, J.: Etiology and pathology of bilateral bundle branch block in relation to complete heart block. Progr. Cardiovas. Dis., 6: 409, 1964. – reference: 7)Pick. A. and Langendorf, R.: Atrioventricular and Intraventricularblock. in Interpretation of complex arrhythmias. Philadelphia. Lea&Febiger 1979. p. 300. – reference: 13) Narula, O. S.: Alternating Bundle branchbrock, in CardiacArrhythmias: Electrophysiology, diagnosis and management. Baltimore, Williams & Wilkins. 1979. p. 128. – reference: 14) Schamroth, L.: Bilateral bundle branch block. in the Disorders of Cardiac rhythm. Chap. 36, Oxford & Edinburgh, Blackwell ScientificPubl., 1971. p. 181. – reference: 6) Rosenbaum, M. B., Elizari, M. V., Lazzari, J. O., Nau, G. J., Halpern, M. S. and Levi, R. J.: The differential electrocardiographic manifestations of hemiblocks, bilateral bundle branch block and trifascicularblocks. in Advances inelectrocardiography. ed. bySchlant, R. C. and Hurst, J. W. New York and London. Grune & Stratton, 1972. p. 145. – reference: 11)Iannone, L. A., Glasser, S. P. and MaCarty, R. J.: His bundle electrogram in trifasciculardisease: Report of a case studied with His bundle electrograms. J. Electrocardiology, 8: 269, 1975. – reference: 3) Grieco, M. H., Schwartz, M. J. and Childs, E. P.: True bilateral bundle branch block. Am. J. Cardiol., 11: 666, 1963. – reference: 16)三羽啓夫, 三浦克也, 岩井雄可小林正明, 熊谷悦子, 志場正光: 通常12誘導心電図でほぼ診断し得たDual AV nodal pathways の電気生理学的検討. 心臓, 13: 183, 1981. |
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| Snippet | 交代性脚ブロックの1 例を経験したのでヒス束心電図所見を中心に報告する.71歳女,主訴は失神発作.心電図所見:1)1:1房室伝導,右脚ブロック,PQ 0.18秒,2)2:1房室伝導,右... |
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| SubjectTerms | ヒス束心電図 両脚ブロック 交代性脚ブロック |
| Title | 症例 交代性脚ブロックの1例 |
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