窄QRS波心动过速的鉴别与射频电消融术靶点定位的对比分析  

Differential Diagnosis of Narrow QRS Tachycardia and Comparison with Radiofrequency Ablation

作　　者：李广平[1] 李忠诚[1] 刘洪[1] 徐延敏[1] 强北平[1] 苏新华[1] 樊振旺[1] 陈欣[1] 

机构地区：[1]天津医科大学第二医院心脏科,300211

出　　处：《天津医药》1995年第5期259-262,共4页Tianjin Medical Journal

摘　　要：结合射频电消融成功者的靶点定位,对房室结折返性心动过速(AVNRT)和显性或隐匿性房室旁路逆传的房室折返性心动过速(AVRT)进行分析。结果显示,AVNRT 78.57％可见位于QRS波终末部分的逆行P’波,在Ⅱ、Ⅲ、aVF导联常表现为伪s波,在aVR和V_1导常表现为伪r波;AVRT逆行性P’波位于QRS波之后,QRS-P’和S-P’间期分别为168±16ms和85±14ms。伴束支阻滞的AVRT的周期对鉴别房室旁路的定位有重要价值。The electrocardiographic features of narrow QRS tachycardia and comparison with radiofre-quency ablation were analysed in 14 patients with atrioventricular nodal re-entrant tachycardia (AVNRT)and 26 with narrow QRS tachycardia due to overt or concealed atrioventricular accessory pathway (AVRT). The results suggesred that retrograde P' waves could not be seen or could be seen on the end of QRS complex like S wave in lead Ⅱ,Ⅲ,aVF and r wave in lead V1 and aVR(so-called pseudo S or r wave)in patients with AVNRT. We measured the QRS-P' and S-P' intervals from the onset of QRS complex or the deepest point of S wave to the deepest point of retrograde P' wave behind QRS complex in patients with AVRT. The QRS-P' and S-P' intervals were 168±16 ms and 85±14 ms respectively. It was difficult to differentiate the AVRT from AVNRT, left and right atrioventricular accessary pathway by the directions of retrograde P' waves. The cycle length of AVRT with bundie branch block might be helpful for the differentiation of left and right atrioventricular accessory pathways.

关 键 词：心动过速 射频消融术 鉴别诊断 

分 类 号：R541.71[医药卫生—心血管疾病]