MACRO-REENTRY WITHIN THE HIS PURKINJE SYSTEM
MACRO-REENTRY WITHIN THE HIS PURKINJE SYSTEM
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DOI：
10.1111/j.1540-8159.1983.tb04440.x
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发表时间：
1983-01-01
影响因子：
1.8
通讯作者：
MAHMUD, R
中科院分区：
文献类型：
--
作者：
AKHTAR, M;DENKER, S;MAHMUD, R
这种沟通涉及一种形式的折返，在此期间，束支（BB）、希氏束（H）和心室心肌（VM）都被纳入回路。这种所谓的大折返His-浦肯野系统（Re-HPS）（也称为束分支折返）在His和束分支内传导正常的患者的室性早搏（V2）期间相对常见。Re-HPS的总体发生率各不相同，但在起搏心室驱动期间具有正常心室内传导（NIVC）的患者中，约有50%的患者出现这种现象。随着程序心室刺激在快速性心律失常治疗中的应用越来越多，认识这种生理反应变得越来越重要。起搏V2也可引起各种其他折返现象，并可能导致解释混乱。为了对Re-HPS进行全面综述，必须讨论起搏V2后主要心室反应类型的性质和潜在机制。然而，Re-HPS的电生理特性将在下文中更详细地讨论。
This communication deals with a form of reentry during which both of the bundle branches (BB), tbe bundle of His (H) and tbe ventricular myocardium [VM) are incorporated in the circuit. This so called macro-reentry His-Purkinje system (Re-HPS)(also referred to as bundle branch reentry), is of relatively common occurrence during ventricular premature stimulation (V2) in patients with normal intra-His and bundle branch conduction.'"^ The overall incidence of Re-HPS varies but the phenomenon is seen in approximately 50% of tbe patients who have normal intraventricular conduction (NIVC) during paced ventricular drives. With increasing utilization of programmed ventricular stimulation in the management of tachyarrbythmias, it has become more important to recognize this physiologic response. A variety of other reentrant phenomena can also be elicited by tbe paced V2 and can cause confusion in interpretation.'For a comprehensive review on Re-HPS it is imperative to discuss the nature and underlying mechanisms of the main types of ventricular responses that can follow a paced V2. However the electrophysiologic characteristics of Re-HPS will be discussed in greater detail as follows.