体表12导联心电图对特发性流出道室性心动过速的起源灶定位作用  

Identifying the Origins of Idiopathic Ventricular Outflow Tract Tachycardia With 12-Leads Body Surface Electrocardiographic Patterns

作　　者：狄文成[1] 姚焰[1] 马坚[1] 陈柯萍[1] 张奎俊[1] 张澍[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院心律失常诊治中心,北京市100037

出　　处：《中国循环杂志》2005年第4期252-255,共4页Chinese Circulation Journal

摘　　要：目的分析患者的12导联体表心电图(ECG)形态特征,旨在提出简便的ECG指标来预测特发性流出道室性心动过速起源。方法回顾我院54例经射频导管消融(消融)手术治愈的起源于心室流出道的特发性室性心动过速ECG资料,总结不同部位起源特发性流出道室性心动过速的ECG形态特征。结果不同起源灶有特征性的ECG形态①左心室流出道心内膜起源的ECG100%呈右束支传导阻滞图形,87.5%胸前V6导联出现S波;②左冠状窦起源的100%符合V1或V2导联R/S波幅指数≥30%和R波时限指数≥50%这两个条件;③右心室流出道游离壁起源下壁导联的R波多有切迹,且V2导联的S波振幅较深,胸前导联移行晚。结论12导联体表ECG特征,对特发性流出道室性心动过速起源灶定位有较高的预测价值。Objective： This study aimed to predict the origins of idiopathic ventricular outflow tract by analysing 12-lead body surface electrocardiograms（ECG） of idiopathic ventricular outflow tract tachycardias. Methods： ECG records of 54 inpatients with idiopathic ventricular outflow tract tachycardias in Fu Wai Hospital were analysed to summarize the characteristics. Results： Different sites of idiopathic ventricular outflow tract tachycardia origin had totally different ECG characteristics. ①ECG of left ventricular outflow tract endocardial origin showed 100% of right bundle branch block pattern, with 87.5% of S wave in lead V6. ②D100% of left sinus of Valsalva（LSV） origins fulfilled the criteria of R wave duration index≥50% and R/S wave amplitude index≥30% determined for leads V1 and V2. ③Inferior leads QRS wave of right ventricular outflow tract（RVOT） free-wall origin demonstrated characteristic ‘notching＇ on R wave ; S wave amplitude was deep in V2 leads and late precordial transition was seen for free-wall origin. Conclusion ：Twelve lead body-surface ECG characteristics have a high sensitivity to identify sites of the idiopathic ventricular outflow tract tachycardia origin.

关 键 词：心电图 流出道室性心动过速 特发性 起源灶 

分 类 号：R541.7[医药卫生—心血管疾病]