{"created":"2023-06-19T10:43:45.489596+00:00","id":4062,"links":{},"metadata":{"_buckets":{"deposit":"572934cf-0ba4-4898-97fb-f358c7b893bc"},"_deposit":{"created_by":11,"id":"4062","owners":[11],"pid":{"revision_id":0,"type":"depid","value":"4062"},"status":"published"},"_oai":{"id":"oai:shiga-med.repo.nii.ac.jp:00004062","sets":["77:426:427"]},"author_link":["8772","8774","8776","8771","8773","8775"],"item_4_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2020-12-23","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"4","bibliographicPageEnd":"243","bibliographicPageStart":"235","bibliographicVolumeNumber":"40","bibliographic_titles":[{"bibliographic_title":"心電図"},{"bibliographic_title":"Japanese Journal of Electrocardiology","bibliographic_titleLang":"en"}]}]},"item_4_creator_3":{"attribute_name":"著者別名","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"SHIMIZU, Shoko"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"OKUNI, Chihiro"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"MIYAMOTO, Chika"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"SAWADA, Yuriko"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"FUJISAWA, Yoshihisa"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"KATOH, Takakazu"}],"nameIdentifiers":[{}]}]},"item_4_description_14":{"attribute_name":"フォーマット","attribute_value_mlt":[{"subitem_description":"pdf","subitem_description_type":"Other"}]},"item_4_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"症例は81歳、男性。高度房室ブロックで、洞性P波が房室伝導した際は右脚ブロック型(+30°)のQRS波(以下、心室捕捉A)が現れ、2種類の補充収縮[右脚ブロック型(以下、補充収縮B)、左脚ブロック型(以下、補充収縮C)]が出現し、様々な融合収縮(以下、融合収縮D)を呈する複雑な不整脈を経験した。補充収縮Bは、II誘導でR波が高く、心室捕捉Aに比べてやや右方に偏位(+60°)していた。補充収縮Bおよび補充収縮CのRR間隔は、それぞれ1.65秒、1.68秒と極めて近似した自動能周期であった。心室捕捉Aに続いて、洞性P波と先行心拍とのRP間隔が0.89秒より長くなる補充収縮Bの場合は、順行性に伝導し、補充中枢を脱分極して周期更新するが、0.88秒以下と短くなる補充収縮Cの場合は、ヒス束下部に回り込み、逆行性に不顕伝導して補充中枢を脱分極するため、次の補充収縮は本来の自動能周期よりも長いRR間隔で出現したと考えられた。以上から、本症例はヒス束内triple pathway機能的縦解離が存在しており、心室捕捉Aは左脚後枝束を伝導し、補充収縮Bは左脚前枝束、補充収縮Cは右脚束に補充中枢が局在すると考えられた。","subitem_description_type":"Abstract"},{"subitem_description":"We reported a patient with high-degree atrio-ventricular block with various QRS complexes. While the ventricular captured beats showed right bundle branch block（RBBB）axis +30°（A）, 2 patterns of escape beats, i.e. RBBB axis +60°（B）and left bundle branch block（LBBB）（C）, were observed with cycle lengths 1.65 and 1.68 sec, respectively. Fusion beats of various degrees between B and C were also observed. When RP interval was ＞ 0.89 sec, the P wave depolarized the escape focus antegradely. When RP interval was ≤ 0.88 sec, the P wave did not antegradely depolarize the escape focus but retrogradely depolarized it with some delay, conducting via the lower portion of His bundle transversely. QRS axis of B showed mild rightward shift compared with that of A. With the aforementioned electrocardiographic findings, we concluded that His bundle was functionally dissociated into triple pathway. In addition, the P wave conducting through the bundle connecting to the left posterior bundle branch caused A, and two escape focuses localized in the bundles connecting to the left anterior bundle branch and right bundle branch caused B and C, respectively.","subitem_description_type":"Abstract"}]},"item_4_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"Journal Article","subitem_description_type":"Other"}]},"item_4_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"日本不整脈心電学会"}]},"item_4_relation_11":{"attribute_name":"DOI","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"10.5105/jse.40.235"}],"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"https://doi.org/10.5105/jse.40.235","subitem_relation_type_select":"DOI"}}]},"item_4_relation_28":{"attribute_name":"論文ID（NAID）","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"130007961812","subitem_relation_type_select":"NAID"}}]},"item_4_relation_29":{"attribute_name":"医中誌ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"2021106268","subitem_relation_type_select":"ICHUSHI"}}]},"item_4_rights_12":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"© 2008, Japan Science and Technology Agency"},{"subitem_rights":"日本不整脈心電学会の許可を得て掲載"}]},"item_4_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0285-1660","subitem_source_identifier_type":"ISSN"}]},"item_4_source_id_9":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00358282","subitem_source_identifier_type":"NCID"}]},"item_4_version_type_15":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"清水, 祥子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"大国, 千尋"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"宮本, 知佳"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"澤田, 由梨子"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"藤澤, 義久"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"加藤, 孝和"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2021-12-14"}],"displaytype":"detail","filename":"jse.40.235.pdf","filesize":[{"value":"853.1 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"jse.40.235","url":"https://shiga-med.repo.nii.ac.jp/record/4062/files/jse.40.235.pdf"},"version_id":"d2628999-b5b3-453d-aed0-5f3e9f77efe4"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"ヒス束内縦解離","subitem_subject_scheme":"Other"},{"subitem_subject":"高度房室ブロック","subitem_subject_scheme":"Other"},{"subitem_subject":"補充収縮","subitem_subject_scheme":"Other"},{"subitem_subject":"triple pathway","subitem_subject_scheme":"Other"},{"subitem_subject":"Longitudinal dissociation in the His bundle","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"High-degree atrio-ventricular block","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Escape beat","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Triple pathway","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"ヒス束内triple pathway機能的縦解離が示唆された高度房室ブロックの1症例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"ヒス束内triple pathway機能的縦解離が示唆された高度房室ブロックの1症例"},{"subitem_title":"Triple Pathway Longitudinal Dissociation in the His Bundle in a Patient with High-degree Atrio-ventricular Block","subitem_title_language":"en"}]},"item_type_id":"4","owner":"11","path":["427"],"pubdate":{"attribute_name":"公開日","attribute_value":"2021-12-14"},"publish_date":"2021-12-14","publish_status":"0","recid":"4062","relation_version_is_last":true,"title":["ヒス束内triple pathway機能的縦解離が示唆された高度房室ブロックの1症例"],"weko_creator_id":"11","weko_shared_id":-1},"updated":"2023-06-19T11:20:15.200322+00:00"}