患者男,24岁。因法洛四联症根治术后残余室间隔缺损、肺动脉瓣狭窄,在我院行“室间隔缺损修补术和肺动脉瓣交界分离术”。既往无心动过速病史。术前心电图示窦性心律,完全性右束支传导阻滞和左后分支阻滞(图略)。术后第3天患者突感心悸,心电图为左束支传导阻滞图形宽QRS波群心动过速,电轴左偏,心室率132次/min(附图左)。急查血钾偏低(3.1mmol/L),疑诊为室性心动过速。静脉补钾、静脉注射负荷量利多卡因和胺碘酮,心动过速未能终止。食管心电图示房室比例2:1,诊断为心房扑动,心室内差异性传导。先后食管快速起搏和静脉注射西地兰0.4mg无效。2 Patient male, 24 years old. Due to tetralogy of Fallot after radical residual ventricular septal defect, pulmonary valve stenosis, in our hospital “ventricular septal defect repair and pulmonary valve junction separation.” No previous history of tachycardia. Preoperative ECG showed sinus rhythm, complete right bundle branch block and left posterior branch block (Figure omitted). On the third postoperative day, the patient experienced sudden palpitation. The electrocardiogram showed a wide QRS complex of left bundle branch block with tachycardia, left axis deviation, and ventricular rate of 132 beats / min (left). Rapid investigation of potassium is low (3.1mmol / L), suspected of ventricular tachycardia. Intravenous potassium, intravenous loading lidocaine and amiodarone, tachycardia failed to terminate. Esophageal ECG shows atrioventricular 2: 1 ratio, diagnosis of atrial flutter, ventricular differential conduction. Fast esophageal pacing and intravenous injection of cedilamine 0.4mg invalid. 2