论文部分内容阅读
目的分析心电图aVR和aVL导联QRS波终末部形态在阵发性室上性心动过速(简称室上速)中的鉴别诊断价值。方法选取泰达国际心血管病医院行射频消融的室上速患者371例,男157例,以心内电生理检查结果为金标准,分为慢快型房室结折返性心动过速(SF-AVNRT)组(n=213)和房室旁路作为逆传支的顺向型房室折返性心动过速(OAVRT)组(n=158)。统计分析两组aVR和aVL导联QRS波终未部形态改变(假性r波或终未部切迹)情况。结果与窦性心律时相比,SF-AVNRT组137例aVR导联QRS波终末部形态改变,发生率为64.3%,OAVRT组4例aVR导联QRS波终末部形态改变,发生率为2.5%,两组差异有显著性(P<0.05);SFAVNRT组117例aVL导联QRS波终末部形态改变,发生率为54.9%,OAVRT组3例aVL导联QRS波终末部形态改变,发生率为1.9%,差异有显著性(P<0.05)。结论 aVR和aVL导联QRS波终末部形态对阵发性室上速的鉴别诊断价值具有重要意义。
Objective To analyze the differential diagnosis value of terminal QRS waveform of ECG aVR and aVL leads in patients with paroxysmal supraventricular tachycardia (SVS). Methods Tida International Cardiovascular Hospital, 371 cases of supraventricular tachycardia patients with radiofrequency ablation, 157 male patients, the results of electrophysiological examination as the gold standard, divided into slow fast atrioventricular nodal reentrant tachycardia (SF- AVNRT) group (n = 213), and atrioventricular bypass as atrioventricular reentrant tachycardia (OAVRT) group (n = 158). Statistical analysis of the two groups aVR and aVL lead QRS wave did not part of the final morphological changes (false r wave or the last part of the notch) situation. Results Compared with sinus rhythm, 137 cases of aVR lead in SF-AVNRT group changed the shape of terminal QRS wave, the incidence rate was 64.3%. In the OAVRT group, 4 cases of aVR lead QRS terminal terminal morphology change, the incidence rate was 2.5%, there was significant difference between the two groups (P <0.05). In the SFAVNRT group, 117 cases of aVL lead terminal QRS wave terminal morphological changes, the incidence was 54.9%, 3 cases of OAVRT group aVL lead QRS terminal apex waveform changes , The incidence was 1.9%, the difference was significant (P <0.05). Conclusion The morphological features of the terminals of QRS in aVR and aVL leads are of great significance for the differential diagnosis of paroxysmal supraventricular tachycardia.