QRS波形态多变逸搏及逸搏心律的原因探讨  

Analysis of the mechanisms of QRS wave diversity in escape beat and escape rhythm

作　　者：唐宝龙[1] 时志城[1] 

机构地区：[1]安徽医科大学第四附属医院,230022

出　　处：《临床心电学杂志》2011年第3期192-194,共3页Journal of Clinical Electrocardiology

摘　　要：目的探讨逸搏QRS波形态多变的原因。方法通过常规心电图及动态心电图对12例QRS波形态多变的逸搏及逸搏心律图形特征的心电图资料进行分类,根据QRS波形态学特征以及QRS波之间的内在联系,确定其起源及心电异常,从而明确其产生原因。结果导致逸搏QRS波形态多变的原因包括:①存在两种及两种以上起源;②伴有时相性和非时相性室内差异性传导;③比例不等室性融合波;④伴间歇性束支、分支阻滞或伴束支文氏现象;⑤存在逸搏节律点游走。结论确定QRS波形态多变的逸搏及逸搏心律的形成原因,对于评价各种传导障碍的性质及临床诊治具有重要的参考价值。Objective To study the mechanisms of QRS wave diversity in escape beat and escape rhythm.Methods Twelve-lead electrocardiograms（ECG） with QRS wave diversity were from conventional ECG and Holter and were analyzed.The origins of QRS waves and concurrent ECG abnormalities were determined according to the morphology and correlation of QRS waves.Results The mechanisms of QRS wave diversity in escape beat and escape rhythm are as follows：①there are two and more origins of QRS maves;②There are phasic and non-phasic aberrant ventricular,conduction along;③There are ventricular fasion waves without fixed proportion;④There＇s intermittence bundle branch block,fascicular block or fascicular wenckebach phenomenon;⑤There＇s wandering escape pacemaker.Conclusions Understanding the reasons and mechanisms of QRS wave diversity in escape beat and escape rhythm is of great reference value for the evaluation,diagnosis of all kinds of conduction block.

关 键 词：心电图 逸搏心律 

分 类 号：R540.41[医药卫生—心血管疾病] R541.7[医药卫生—内科学]