论文部分内容阅读
贵刊转来闾医师来信,对他的关心拙文表示感谢! 本文判为房颤、完全性AVB、房室交界性起源伴左束支内文氏型阻滞,闾医师根据R-R的变动(1.40～1.50 s)和QRS外形,认为是“近乎同步等频之双灶性(双束支主干型)室性自搏心律,有时伴不同程度室内绝对干扰造成类似左束支内的直接显示性文氏现象及右束支内的不全隐匿性文氏现象。”为本图的解释增添了另一种可能性,对于提高心电分析是有益的。确实,当年Friedberg与Schamroth提出的束支内文氏传导的心电标准中,要求有非常规则的窦性(或其他室上性)心律这一点,即R-R要求绝对相等。但是这种看法已受到置疑(王恒润:上海医学1979年第2期),认为“应作补充修改”。在Ⅲ°AVB时,即使可明确判定源于交界区的起搏,其R-R也不是“绝对匀齐”,何况已有交界性混乱心律的报告(冯海新,实用心科杂志,1982年第5期) 周知,体表心电图对于房、室活动及其间的传导关系,具有很大程度上的推理性。我们主要根据QRS由窄→宽及由宽→窄之逐渐变化予以推断,并结合各种心律失常出现之概率予以判定。着眼于左束支之文氏型传导。闾
Your translation of the letter to Dr.Lv, his clues to my thanks! This sentence was sentenced to atrial fibrillation, complete AVB, atrioventricular borderline with left bundle branch in-type block, Dr. Lu according to RR changes (1.40 ~ 1.50 s) and QRS appearance as “near-synchronous dual-foci of bifocal (two-bundle branch) ventricular pacemaker, sometimes accompanied by varying degrees of absolute interference within the room causing direct display of text within the left bundle branch ’S phenomenon and incomplete bundle of hidden Wen’s phenomenon within the right bundle branch. ”The interpretation of this figure adds another possibility that is useful for improving ECG analysis. Indeed, Friedberg and Schamroth’s proposed bundle-guided intraventricular conduction ECG standard requires a very regular sinus (or other supraventricular) heartbeat in which R-R requirements are absolutely equal. However, this view has been questioned (Wang Hengrun: Shanghai Medical 2, 1979), that “should be amended.” In the Ⅲ ° AVB, even if it can be clearly determined from the junction of pacing, the RR is not “absolutely homogeneous”, not to mention the report of borderline confusion rhythm (Feng Haixin, Practical Heart Journal, 1982 fifth period ) It is well known that the body surface ECG has a great deal of reasoning about the accommodation and the conduction in the room. We mainly inferred from the gradual changes of narrow → wide and wide → narrow narrowed by QRS, and combined with the probability of occurrence of various arrhythmias. Focus on the left bundle branch of the Venturi conduction. Lu