显性间隔部房室旁路的体表心电图定位诊断  

Electrocardiographicalgorithmforlocalizationofseptalaccessorypathways

作　　者：董剑廷[1,2,3] 胡大一[1,2,3] 盛蕙敏 陈惠斌 马长生[1,2,3] 杨新春[1,2,3] 商丽华[1,2,3] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院心脏中心 [2]中国医科大学第一附属医院心内科 [3]北京中日友好医院心内科

出　　处：《中华心血管病杂志》1996年第6期421-424,共4页Chinese Journal of Cardiology

摘　　要：本文回顾分析已成功进行射频消蚀、定位诊断明确的６１例间隔旁路患者的体表心电图。各部位旁路心电图特点：（１）Ｖ１导联呈ｒＳ型或δ波为负向为右侧旁路，否则为左侧旁路；（２）右侧间隔旁路的特点：Ｖ１导联δ负向或Ｖ１呈ｒＳ型且ｒ＜４０ｍｓ，Ｖ２Ｒ／Ｓ≥１，敏感性９６％，特异性９８％）；（３）右前间隔Σδ≥＋２，右中间隔－１≤Σδ＜＋２，右后间隔Σδ＜－１；（４）左后间隔旁路：Ｖ１呈“Ｍ”型右束支阻滞图形或ＲＳ型且Ｒ／Ｓ型＝１，Ⅱ导联δ波为负向（敏感性９０％，特异性９９％）。总之，根据体表心电图Ｖ１、Ｖ２、Ⅱ、Ⅲ。The12-leadelectrocardiogramsof61patientswithoneanterogradelyconductingsep-talaccessorypathywaywereanalyzedretrospectivelytoinvestigatethecharateristicsoftheelectro-cardiographicfindingsinrightandleftseptalAPlocation.Locationofaccessorypathywaywascon-firmedbyradiofrequencycatheterablation.IfnegativedeltawaveinleadV1orrSpatterninleadV1wasfound,itwasright-sided;otherwise,itwasleft-sided.IfnegativedeltawaveorrSpaterninV1andr<40ms,V2R/S>1wasfound,itwasrightseptalaccessarypathway(AP),otherwiseitwasrightfreewalAP(sensitivity96%,sepecificity98%).RightanteriorseptalΣδ≥+2,rightmedianseptal-1≤Σδ<+2,rightposteriorsaptalΣδ<-1.Thecharacteristicsofleftposteriorseptal“M”paternofrightbundlebranchblockinleadV1orRSpatern(R/S=1)inleadV1withnegativedeltawaveinleadⅡwasfoundin90%ofthepatientsinLPSbutonly2%ofthepatientswithleftfreewalAP(P<0.01).Thiscriteriahadasensitivityof90%andspecificityof99%tolocalizeLPS.FiveECGleads(leadV1,V2,Ⅱ,Ⅲ,aVF)areenoughforlocalizingseptalAPwithhighsensitivityandspecificity.

关 键 词：预激综合征 心电图 导管消融 诊断 

分 类 号：R541.770.4[医药卫生—心血管疾病]