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目的观察12导联动态心电图间歇性完全性左束支阻滞出现前后心电图QRS波群形态改变特点。方法选择2005年1月至2009年3月住院的16158例患者的12导联动态心电图,检出间歇性完全性左束支阻滞16例,占0.9‰,并对完全性左束支阻滞时心电图QRS波群形态改变的特点进行分析。结果①平均QRS电轴:完全性左束支阻滞时33.64±59.77°,正常室内传导时68.36±13.70°,二者比较,p=0.038;②QT间期:完全性左束支阻滞时0.44±0.07s,正常室内传导时0.40±0.08s,二者比较,p<0.001;③V2导联r波振幅:完全性左束支阻滞时0.13±0.08mV,正常室内传导时0.41±0.28mV,p=0.02。结论间歇性完全性左束支阻滞发生率较低,心电图主要特点为QRS电轴左偏,QT间期延长,V2导联r波振幅明显降低或消失,QRS波群总振幅无明显改变,上述特点有助于识别动态心电图中的间歇性完全性左束支阻滞。
Objective To observe the morphological changes of ECG QRS complex before and after the intermittent complete left bundle branch block of 12-lead Holter. Methods The 12-lead ambulatory electrocardiogram of 16,158 patients hospitalized from January 2005 to March 2009 were retrospectively analyzed. Sixteen patients with intermittent complete left bundle branch block (0.9%) were diagnosed, and the complete left bundle branch block When ECG QRS wave group morphological changes were analyzed. Results ① The average QRS axis: complete left bundle branch block 33.64 ± 59.77 °, normal room conduction 68.36 ± 13.70 °, the two compared, p = 0.038; ② QT interval: complete left bundle branch block 0.44 ± 0.07s, and normal room conduction was 0.40 ± 0.08s, p <0.001. (2) The r-wave amplitude of V2 lead: 0.13 ± 0.08mV in complete left bundle branch block and 0.41 ± 0.28mV in normal room conduction, p = 0.02. Conclusions The incidence of intermittent complete left bundle branch block is low. The main features of electrocardiogram are left deviation of QRS axis, prolongation of QT interval, amplitude of r-wave of v2 lead significantly decrease or disappear, total amplitude of QRS complex has no obvious change, These features help to identify intermittent complete left bundle branch block in the Holter.