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目的研究预激综合征(WPW)伴心房颤动(Af)的机制与室性心动过速(VT)的关系,提出正确诊断与及时治疗的方法。方法对20例WPW伴Af患者的心电图及临床治疗资料进行分析。结果 20例患者常规心电图均记录到窦性心律,显示典型预激图形。Af阵发性发作时QRS波呈快速增宽且宽窄不等,部分QRS波起始处可见到δ波,显示WPW伴Af。心室率170~230 bpm,其中11例为170~190 bpm,7例为190~210 bpm,2例为210~230 bpm。有8例患者记录到房室折返心动过速(AVRT),其中6例为前向折返性,2例为逆向折返性。结论 WPW伴快速心室率的Af最严重的结果是演变成VT与心室颤动,最终导致患者死亡。所以对WPW伴快速心室率Af的患者应尽快尽早给予治疗,使Af时心室率减慢并转为窦性心律。
Objective To study the relationship between WPW and atrial fibrillation (AF) and ventricular tachycardia (VT) and to provide a correct diagnosis and timely treatment. Methods The electrocardiogram and clinical data of 20 patients with WPW and Af were analyzed. Results The sinus rhythm was recorded in all 20 patients with conventional electrocardiogram, showing the typical pre-excitation pattern. Af paroxysmal seizures QRS wave showed rapid widening and varying width, some QRS wave can be seen at the beginning of δ wave, showing WPW with Af. Ventricular rates ranged from 170 to 230 bpm, with 11 to 170 to 190 bpm, 7 to 190 to 210 bpm and 2 to 210 to 230 bpm. Eight patients recorded AVRT, of which 6 were retrograde and 2 were retrograde. Conclusions The most serious consequence of WP with rapid ventricular rate in WPW is the evolution of VT to ventricular fibrillation, which eventually leads to death. Therefore, patients with WPW with fast ventricular rate Af should be treated as soon as possible so that Af when the ventricular rate slowed and converted to sinus rhythm.