A 29-year-old woman without known medical illness was evaluated for incessant palpitations. She presented to an emergency department multiple times, where various diagnoses were made, including junctional tachycardia, atrial tachycardia, and atrial fibrillation. Therapy with propafenone, metoprolol, and rivaroxaban was initiated, but her symptoms continued. Echocardiography did not show evidence of structural heart disease. The patient was then referred to our hospital for further treatment and potential ablation for atrial fibrillation. At her clinic visit, a 12- ECG revealed an irregular narrow complex tachycardia with group beating pattern (Figure 1). Figure 1. Twelve-lead electrocardiography shows narrow complex tachycardia with group beating pattern. What is the rhythm shown in Figure 1? Please turn the page to read the diagnosis. P waves arising from the sinus node are seen at a rate of 66 beats per minute. Each P wave is followed by 2 QRS complexes until the tachycardia terminates, followed by reinitiation of tachycardia with the same pattern. The double ventricular response to a single atrial activation, called 1 to 2 atrioventricular conduction …

中文翻译：

---

29岁女性不规则狭窄的复杂性心动过速

对一名29岁无已知病的女性进行了持续性心评估。她多次到急诊室就诊，在那里进行了各种诊断，包括结节性心动过速，房性心动过速和房颤。开始使用普罗帕酮，美托洛尔和利伐沙班治疗，但症状持续。超声心动图未显示出结构性心脏病的证据。然后将患者转诊到我们医院接受进一步治疗，并可能消融房颤。在她的诊所就诊时，一个12心电图显示出一个不规则的狭窄的复杂心动过速，并伴有跳动模式（图1）。图1.十二导联心电图显示狭窄的复杂心动过速，表现为跳动模式。图1所示的节奏是什么？请翻页阅读诊断。窦房结产生的P波以每分钟66次的速度被看到。每个P波后跟随2个QRS波，直到心动过速终止，然后以相同的模式重新开始心动过速。对单个心房激活的双心室反应，称为1至2房室传导…