预激综合征QRS终末波极性对肯特束的定位价值  

The Value of Polarity of QRS Terminal Wave in Determining Site of Kent Bundle in Preexcitation Syndrome

作　　者：任在镐[1] 胡大一[2] 许春萱[3] 余培桢[4] 

机构地区：[1]浙江大学医学院附属第二医院心内科,310009 [2]北京大学人民医院心内科 [3]福建省心血管病研究所 [4]中国医学科学院阜外心血管病医院电生理室

出　　处：《心电学杂志》2008年第3期191-194,共4页Journal of Electrocardiology(China)

摘　　要：目的研究预激综合征QRS终末波的特征性规律,探索其对肯特束的定位价值。方法连续累积327例射频导管消融成功的单支顺传性旁束的心电图作研究。将全心分为10区。按区计算各导联终末S波的出现率和95%的可信区间(C1)。结果97.8%的右心室旁束I导联无终末S波,CI为0.95￣0.995。在右心室旁束中,若aVR出现终末R波可排除右前间隔和右前壁旁束,CI为0.92￣1.00;若aVL出现终末S波可排除右后间隔和右后壁旁束,CI0.96￣1.00。结论了解预激综合征QRS终末波的规律,可为心电图对肯特束的定位提供更多的可靠指标。Objective To evaluate characteristics of QRS terminal wave and its value in determining site of Kent bundle in preexcitation syndrome. Methods The electrocardiograms were analyzed retrospectively in 327 consecutive patients with one anterograde conduction bypass ablated successfully. The whole heart was divided into 10 areas. The rate of appearance of the terminal S wave of all leads in each area and its confidence interval（Cl） of 95.0% were calculated. Results There was no terminal S wave in lead I in 97.8%of right ventricular bypass and the CI was 0.95-0.995. Terminal R in aVR excluded the possibility of right anteroseptal and right anterior pathways and the Cl was 0.92 - 1.00. Terminal S in aVL excluded the possibility of right posteroseptal and right posterior pathways and the Cl was 0.96 - 1.00. Conclusion The characters of QRS terminal wave in electrocardiogram maybe used to determine site of Kent bundle in preexcitation syndrome.

关 键 词：预激综合征 肯特束 QRS终末波 导管射频消融 各向异性 

分 类 号：R541.7[医药卫生—心血管疾病]