Second-degree atrioventricular block.
Second-degree atrioventricular block.
复制标题
二度房室传导阻滞。
DOI：
10.1161/01.cir.60.3.465
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发表时间：
1979
期刊：
影响因子：
37.8
通讯作者：
D. Zipes
中科院分区：
文献类型：
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作者：
D. Zipes
1）虽然电生理学上可能只存在一种类型的二度房室传导阻滞，但现有数据并不能证明这样的结论是合理的，并且似乎更适合保持“分裂者”并主张多种机制的分离和定义，而不是成为“集中者”并接受统一的概念。 2) I 型和 II 型房室传导阻滞的临床分类，基于现有的标量心电图标准，在很大程度上准确地区分了临床上重要的患者类别。这种分类是描述性的，但具有有用的功能，应该保留，考虑到上述注意事项。阻滞部位通常决定患者的临床病程。对于大多数房室传导阻滞的例子，目前使用的 I 型和 II 型分类是基于房室传导阻滞的部位。由于 His-Purkinje 系统中的阻滞之前有小的或不可测量的增量，因此称为 II 型 AV 阻滞；但它之前有小增量的事实是因为它发生在希斯-浦肯野系统中。类似的逻辑可以应用于 AV 节点中的 I 型 AV 块。例外情况确实会发生。如果无法通过标量心电图准确地区分房室传导阻滞的部位，电生理学研究通常会揭示答案。
1) While it is possible only one type of second-degree AV block exists electrophysiologically, the available data do not justify such a conclusion and it would seem more appropriate to remain a "splitter," and advocate separation and definition of multiple mechanisms, than to be a "lumper," and embrace a unitary concept. 2) The clinical classification of type I and type II AV block, based on present scalar electrocardiographic criteria, for the most part accurately differentiates clinically important categories of patients. Such a classification is descriptive, but serves a useful function and should be preserved, taking into account the caveats mentioned above. The site of block generally determines the clinical course for the patient. For most examples of AV block, the type I and type II classification in present use is based on the site of block. Because block in the His-Purkinje system is preceded by small or nonmeasurable increments, it is called type II AV block; but the very fact that it is preceded by small increments is because it occurs in the His-Purkinje system. Similar logic can be applied to type I AV block in the AV node. Exceptions do occur. If the site of AV block cannot be distinguished with certainity from the scalar ECG, an electrophysiologic study will generally reveal the answer.