室性早搏二联律伴发的特殊心电现象  

Special electrophysiological phenomena with ventricular premature beats of bigeminy

作　　者：时志城[1] 韩卫星[2] 

机构地区：[1]安徽医科大学第四附属医院,合肥230022 [2]安徽医科大学第一附属医院

出　　处：《实用心电学杂志》2010年第5期370-373,共4页Journal of Practical Electrocardiology

摘　　要：目的探讨室性早搏二联律发生过程中所伴发特殊心电现象的主要心电图表现及形成机制。方法回顾性分析18例室性早搏二联律患者常规心电图及动态心电图中伴发的特殊心电现象。结果观察到6种特殊现象:①1∶1电交替现象;②交替性手风琴现象;③折返径路内文氏及反文氏现象;④偶联间期文氏型室性并行心律中部分窦性心搏伴室内差异性传导现象;⑤与房性早搏同步发生形成不同程度室性融合波;⑥室房双径路传导现象,间歇性1∶2室房同步传导及心室回波。结论这些现象常呈一过性或暂时性改变,心内电生理检查不易复制,认识这些心电现象并了解其形成机制,有助于提高心电图诊断能力,并为临床进一步诊治提供帮助。Objective To explore electrocardiogram(ECG)changes and the mechanisms of special electrophysiological phenomena with ventricular premature beats(VPB) of bigeminy.Methods VPB of bigeminy with special electrophysiological phenomena were analyzed retrospectively on ECG or ambulatory ECG in18 patients.Results Six kinds of special phenomena were identified as following:①1:1 electrical alternation phenomena;②alternative concertina phenomena; ③Wenckebach and reversed Wenckebach phenomena on reentrant tachycardia; ④some sinus beats companied with ventricular aberrant conduction in coupling interval of the Wenckebach ventricular parasytole;⑤Different degrees of ventricular fusion waves because of syuchronous occurrence of VPB and atrial premature beats;⑥Ventriculoatrial conduction(VAC) by dual pathways,intermittent occurrence of 1:2 synchronous VAC and ventricular echo beats.Conclusion These phenomena emerge transiently and cannot be copied through intracardiac electrophysiologic study,knowing these ECG findings and their mechanisms may supply help to the ECG diagnosis and clinical treatment.

关 键 词：室性早搏二联律 心电现象 形成机制 心内电生理检查 室内差异性传导 室性并行心律 心电图诊断 室性融合波 回顾性分析 动态心电图 常规心电图 心室回波 文氏现象 同步 特殊现象 房性早搏 发生过程 一过性 文氏型 双径路 

分 类 号：R54[医药卫生—心血管疾病]