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患者女性,37岁,因反复劳累后胸闷、气促近4年伴咳嗽、咯血丝1月就诊。无昏厥史。心脏听诊:心率约40次/min,心律不齐,各瓣膜区无杂音。心电图Ⅱ导联连续描记(附图)见心率平均46次/min,上行 P_(1—8)、下行 P_1—3)、P_(5—7)为逆行 P 波(P~-),均落在 ORS 波群之前,其 P~--P~-间距极不规则,上行 P_1~--P_2~-最长达2.71s,最短P_3~--P_4~-间距为1.14s,但 P~--R 固定为0.12s;下行 R_3-R_4为1.60s,R_4-R_5为1.58s,R-R 间距基本固定。下行 P_4~-落在 QRS 波之后,R-P~-间期0.08s,其 P~--形态与其余 P~--形态不同,下行 R_5前后无 P~--波。图中箭头所示为窦性 P 波,(即 P波提前发生,P-R 间期>0.12s,在 P_(Ⅱ、aVF)表现为
Female patient, 37 years old, due to repeated exertion after chest tightness, shortness of breath nearly 4 years with cough, hemoptysis in January treatment. No syncope history. Cardiac auscultation: heart rate about 40 times / min, arrhythmia, the valve area without noise. Continuation of electrocardiogram Ⅱ lead tracing (with photos) See average heart rate 46 times / min, up P_ (1-8), down P_1-3), P_ (5-7) for the retrograde P wave (P ~ Before the ORS wave group, the P ~ - P ~ - spacing was extremely irregular, the up to P_1 ~ - P_2 ~ up to 2.71s, the shortest P_3 ~ P_4 ~ spacing to 1.14s, but the P ~ -R is fixed at 0.12s; the downlink R_3-R_4 is 1.60s, the R_4-R_5 is 1.58s, and the RR spacing is basically fixed. Downward P_4 ~ - After QRS wave, R_p ~ - interval 0.08s, P ~ - morphology and the remaining P ~ - morphology is different, there is no P ~ - wave before and after downlink R_5. The arrow in the figure shows sinus P wave, (P wave occurs earlier, P-R interval> 0.12s, P_ (II, aVF)