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Sinus arrhythmia with accelerated junctional escape rhythm atrioventricular separation induced by intermittent report of 1 case

01) 【Key Words】 R540.4 Document code】【B】【Article ID 1000-5161 (2004) 02-0069-011 clinical data of patients,[link widoczny dla zalogowanych], female, 68 years old, repeated chest tightness, shortness of breath 5 years,[link widoczny dla zalogowanych], adding to 2d admission. BP18.7/9.3kPa, heart rate 64 times / min, creatine kinase CK1845U / L (0-161U / L) isoenzymes 132U / L (0-24U / L). Clinical diagnosis: coronary heart disease,[link widoczny dla zalogowanych], acute extensive anterior wall myocardial infarction. ECG showed sinus rhythm, arrhythmia,[link widoczny dla zalogowanych], PP interval 0.84S a 1.02S, QRS wave group time 0.10S. R5 a R9, Rl9 a R2l and conduction of the former relationship between P waves, PR interval 0.16S. Rl-R4, Rl0 a Rl8 nothing to do with the P wave,[link widoczny dla zalogowanych], QRS wave group with the former, RR between the junction of 0.96S to accelerate escape rhythm. ECG: sinus arrhythmia associated with accelerated junctional escape rhythm induced by intermittent atrioventricular separation. 2 discussed in acute myocardial infarction, the electrocardiogram recorded easy to think of atrioventricular block atrioventricular separation. It should be noted and interference atrioventricular separation phase identification. At this point the frequency of atrial and ventricular AAVVAAVVAAVV relationship between the frequency of the key differential diagnosis. Fast time in this case the room rate (PP interval 0.88S) won by the download, room rate (PP interval 1.02S) <room rate (RR asked of 0.96S) when atrioventricular separation. Therefore, this patient had intermittent atrioventricular separation, atrioventricular block and do not consider the atrioventricular interference. It should be noted that in this case to speed up the junction escape beat escape beat area, which means increased self-regulation junction, the junction area should be combined with clinical analysis of the clinical significance of increased self-discipline. Accelerated junctional escape rhythm common in patients with heart disease, such as: ① coronary heart disease, especially acute myocardial infarction. ② ③ variety of myocarditis, especially chronic pulmonary heart disease, infection, heart failure ④ cardiomyopathy, hypertension, heart disease, cardiac surgery, bacterial endocarditis ⑤ ⑥ diabetic acidosis, hypokalemia, digitalis ⑦ ⑧ very small number of poisoning, for unknown reasons. The cases of clinical myocardial infarction, myocardial ischemia may be related. Accelerated junctional escape rhythm Although the response junction increased self-discipline, has pathological significance. However, no effect on hemodynamics, and no clinical symptoms, from the perspective of arrhythmia, no special treatment, in this case the primary disease treatment is mainly an acute myocardial infarction treatment. 【Received Date] 2004-03-07 Figure 1, middle, and lower in patients with continuous acts of ECG tracings Ⅱ 【Author] jun (1964 a), male, MD, research interests include clinical internal medicine.
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