预激综合征合并心房颤动临床分析  

Clinical analysis of pre-excitation syndrome complicated with atrial fibrillation

作　　者：孟凡杰[1] 李玲[1] 邹建峰[1] 程晓静[1] 王岩[1] 顾法霖[1] 杨延民[1] 

机构地区：[1]山东省日照市人民医院心内科,276826

出　　处：《中国医药》2009年第11期856-857,共2页China Medicine

摘　　要：目的分析探讨预激综合征合并心房颤动的心电图特征和鉴别诊断及治疗。方法分析16例预激综合征合并心房颤动的心电图特点及QRS波的表现。结果16例预激综合征合并器质性心脏病患者中6例合并有器质性心脏病的患者分别使用普罗帕酮、乙胺碘呋酮及电复律治疗转复为窦性心律；10例无器质性病变者，分别使用普罗帕酮或乙胺碘呋酮治疗转复为窦性心律。QRS波多数为完全预激图形、典型预激图形及正常QRS图形的不同组合。其中大多数病例的QRS波表现表现为预激图形，典型预激图形与正常QRS波群不同组合。极少数患者均呈完全预激图形。结论预激综合征合并心房颤动的心电图特征是极快的心室率，RR间期绝对不等，QRS增宽有8波，QRS波表现为完全预激图形，典型预激图形及正常QRS波的不同组合。合并正常通道一度及三度房室传导阻滞者，全部为完全性预激图形。Objective To analyze the electrocardiogram feature, differential diagnosis and treatment of pre-excitation syndrome complicating atrial fibrillation. Methods Sixteen patients of pre-excitation syndrome complicat- ed with atrial fibrillation. Results The ventricular rate of 16 patients was 160 to 240 beats per minute and the average rate was 182 beats per minute. Most QRS waves appeared with the different combination of complete pre-excitation graph, typical pre-excitation graph and normal QRS waves. Most QRS waves of those patients showed pre-excitation graph. The different combination showed typical pre-excitation graph and normal QRS waves and very few showed complete pre-excitation graph. Conclusions The electrocardiogram features of pre-excitation syndrome complicated with atrial fibrillation showes very rapid ventricular rate, absolute inequality of RR interval, widen QRS waves with delta wave. QRS waves showes complete pre-excitation graph and the different combination of typical pre- excitation graph and normal QRS waves. Those complicating first and third degree atrioventricular block of right way showes complete pre-excitation graph.

关 键 词：预激综合征 心房颤动 诊断 鉴别诊断 

分 类 号：R541.75[医药卫生—心血管疾病]