食管和改良V_1导联同步心电图对心动过速直观定性及定位的意义  

The significance of esophagus and varied V_1 synchronization ECG to determine direct on the nature and position of tachycardia

作　　者：饶利亚[1] 李裕舒[1] 张家明[1] 

机构地区：[1]华中科技大学同济医学院心血管病研究所

出　　处：《临床心血管病杂志》2001年第3期120-122,共3页Journal of Clinical Cardiology

摘　　要：目的 :评价食管和改良 V1导联同步记录心电图对心动过速定性、定位的应用价值。方法 :应用美国 BRENTWOOD1 2导联同步记录心电图机 ,记录 63例心动过速发作时的标准导联和食管及改良 V1导联心电图 ( ECGe+ ECGvv1) ,并分析心动过速的性质和发病机制。结果 :诊断左侧旁路合并 35例 ,右侧旁路 2例均合并房室折返性心动过速 ( AVRT) ;房室结双径路并房室结折返性心动过速 ( AVNRT) 2 4例 ;房性心动过速 2∶ 1传导和室性心动过速 1∶ 1逆传各 1例。除后 2例患者因先天性心脏病行外科手术治疗外 ,余患者均经心内电生理检查和射频电消融治疗所证实。结论 :ECGe+ ECGvv1能分别反映左右心房激动顺序 ,在心动过速定性方面和异位节律点的定位方面具有简单、直接、准确、无并发症等优点和良好的应用价值。Objective:To appraise application value concerned with the determination of the nature and the position of tachycardia by the esophagus and varied V 1 synchronization ECG(ECGe+ECGvv 1).Method:The forthwith synchronal standard ECG, ECGe and ECGvv 1 were recorded during onset of tachycardia in 63 cases using BRONTWOOD 12 leads synchronal electrocardiograph.Result:Of 63 cases, 37 cases were diagnosed as the atrioventricular reentrant tachycardia with 35 cases of left accessory pathways and 2 cases of the right accessory pathways, 24 cases as the dual atrioventricular node pathway with atrioventricular node reentrant tachycardia, a case as atriotachycardia with 2∶1 conduct and a case as ventricular tachycardia.The diagnoseis of patients were proved through the interventional electrophysiologic studies and the radiofrequency ablation except last two patients undergoing surgical treatment because of congenital heart diseases.Conclusion:Synchronal ECGe and ECGvv 1 can separately reflect gradation of left and right atrial excite, and can simply, directly and accurately determine the nature of tachycardia and the position of arrhythmia without complication. It is worth to apply and to extend.

关 键 词：心动过速 心电描记术 直观定性 定位 

分 类 号：R541.71[医药卫生—心血管疾病] R540.41[医药卫生—内科学]