对比
二度I型房室传导阻滞（文氏型） vs 二度II型房室传导阻滞: 临床与心电图鉴别
基于MioAtlas 3D心脏模拟器模型的二度I型房室传导阻滞（文氏型）与二度II型房室传导阻滞横向对比。
按解剖生理分层与诊断参数列出的表现
| 层面 / 表现 | 二度I型房室传导阻滞（文氏型） | 二度II型房室传导阻滞 |
|---|---|---|
| 临床概要 |
连续心搏中PR间期进行性延长，直至一个P波无法下传（P波脱落）。随后的长间歇短于两个正常窦性周期之和，之后周期重新开始。几乎总是位于房室结内；通常良性且可逆（迷走神经张力过高、下壁STEMI、药物影响）。 |
房室传导突然中断，间歇性出现P波脱落，而脱落前并无PR间期进行性延长。阻滞部位位于希氏束或束支系统（结下阻滞）。极易恶化为希氏束下完全性房室传导阻滞及阿-斯综合征（Stokes-Adams晕厥）；为植入永久起搏器的绝对适应证。 |
| 心率 |
68 bpm (min: 50, max: 90) |
55 bpm (min: 40, max: 75) |
| QRS时限 |
90 ms |
130 ms |
| 发生机制 |
bloqueo |
bloqueo |
| AV传导 |
wenckebach |
variable |
| 关键导联 |
II |
II, V1 |
文献来源与参考文献
二度I型房室传导阻滞（文氏型）
- Anderson RH, Yanni J, Boyett MR, Chandler NJ, Dobrzynski H. The anatomy of the cardiac conduction system . Clin Anat (2009) . DOI: 10.1002/ca.20700
- Kligfield P, Gettes LS, Bailey JJ, et al. Recommendations for the standardization and interpretation of the electrocardiogram: Part I: The electrocardiogram and its technology . Circulation (2007) . DOI: 10.1161/CIRCULATIONAHA.106.180200
- Surawicz B, Childers R, Deal BJ, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: Part III: Intraventricular conduction disturbances . Circulation (2009) . DOI: 10.1161/CIRCULATIONAHA.108.191095
二度II型房室传导阻滞
- Anderson RH, Yanni J, Boyett MR, Chandler NJ, Dobrzynski H. The anatomy of the cardiac conduction system . Clin Anat (2009) . DOI: 10.1002/ca.20700
- Kligfield P, Gettes LS, Bailey JJ, et al. Recommendations for the standardization and interpretation of the electrocardiogram: Part I: The electrocardiogram and its technology . Circulation (2007) . DOI: 10.1161/CIRCULATIONAHA.106.180200
- Surawicz B, Childers R, Deal BJ, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: Part III: Intraventricular conduction disturbances . Circulation (2009) . DOI: 10.1161/CIRCULATIONAHA.108.191095