【作者】 张慧萍；

【导师】 赵明厚； 肖传实；

【作者基本信息】 山西医科大学 ， 心内科， 2005， 硕士

【摘要】 目的:分析经射频消融术证实的59例由房室结双径路引起的房室结折返性心动过速(AVNRT)和40例由隐性房室旁路引起的房室折返性心动过速(AVRT)患者的窦性心律与发作室上速时的体表心电图,总结具有特异性改变的P-QRS波型,提高体表心电图鉴别室上性心动过速的发生机制以及诊断房室结双径路与隐性旁路的准确率。 方法:99例窄QRS波心动过速患者均接受心内电生理检查,并经射频消融治疗获得成功,分析其射频消融术前窦律下与发作室上速时12导联体表心电图的P-QRS波型。 结果:1.99例室上速中AVNRT为59例,AVRT为40例,10例AVRT中射频消融术前窦律下V1导联呈rSr’为5例,59例AVNRT为6例,分别占12.50%和10.17%,无显著差异(P>0.05);但在40例AVRT中术前窦律下V6导联呈qRs为24例,59例AVNRT仅21例,分别占60.00%和35.59%,有显著差异(P<0.05)。2.射频清融术前窦律心电图与发作室上速时12导联体表心电图比较,由于逆P(P’)使V1导联呈rSr’,59例AVNRT中43例,发生率72.88%;40例隐性旁路病人7例,发生率17.5%;有显著差异(P<0.01)。 结论:1.窦律心电图V6导联qRs三相波形对隐性预激诊断特异性强,准确性高。2.室上速时,V1导联呈rSr’多提示AVNRT。更多还原

【Abstract】 Objective This study aimed to finding the faster, simpler,better methods that evaluate AVNRT and AVRT. We analyzed the surface ECG of 59 patients with dual atrioventricular nodal pathway(DAVNP) and the surface ECG of 40 patients with concealed W-P-W syndrome, which were confirmed by radiofrequency catheter ablation (RFCA). During sinus rhythm and tachycardia, summarized the distinguishing features of ECG to increase the diagnostic accuracy of atrioventricular nodal reentrant tachycardia (AVNRT)and concealed W-P-W syndrome(AVRT).Methods Five-nine patients with AVNRT and forty patients with AVRT who were confirmed by RFCA and divided into A and B groups. 1.We compared the surface ECC in 12 leads during sinus rhythm between A and B groups. 2.We compare the surface ECC in V1 leads during sinus rhythmwith tachycardia and try to find the relation between the different locations of retrograde P’ wave and QRS complex in V1 lead.Results 1. During sinus rhythm with rSr’ complex in VI lead; there were 6 with rSr’ complex in A group patients’ ECG, the occurrence rate was 12.5 %;There were 5 patients in B group patients’ ECG ,the occurrence rate 10.17% ; P>0.05. But during sinus rhythm with qRs complex in V6 lead; there were 21 in A group patients’ ECG, the occurrence rate was 35.6%;There were 24 patients in B group patients’ ECG ,the occurrence rate 60.0% ; P <0.05. 2. Compare the surface ECC during sinus rhythm with tachycardia, because of retrograde P( P’), QRS wave becomes rSr’ in V1 leads, there were 43 in A group patients’ ECG, the occurrence rate was 72.88%; There were 7 patients in B group patients’ ECG , the occurrence rate 17.5% ; P <0.01. Conclusions 1.To observe the qRs complex in V6 lead during sinus rhythm更多还原