右心室流出道起搏电极定位的心电图研究  

Electrocardiographic research of lead location in right ventricular outflow pacing

作　　者：陆敏[1] 周建龙[1] 金骁琦[1] 盛晓东[1] 范韬[1] 

机构地区：[1]扬州大学医学院附属常熟医院心血管内科,江苏省常熟市215500

出　　处：《中国心血管病研究》2016年第4期337-340,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨右心室流出道起搏的电极放射影像定位与心电图特点对确定起搏导线植入位置的临床意义。方法选取扬州大学医学院附属常熟医院心内科过去6年间植入DDD永久起搏器的缓慢性窦房结功能失调或Ⅱ。以上房室传导阻滞患者，采用主动固定螺旋电极行右室流出道起搏，根据室间隔起搏的部位不同分为高位、中位、低位组。评价不同部位起搏患者术中12导联心电图特征，包括QRS波形态、时限及振幅。结果符合入选标准且完成起搏器植入的患者共计98例，中间隔起搏QRS波时限最短（139±21）ms，较之高位间隔起搏有差异。间隔部起搏位置升高，胸前导联R／S移行越靠前。下壁导联R波振幅与间隔部起搏位置存在相关。结论右心室流出道起搏术中心电图分析对室间隔起搏电极定位有实用性意义。Objective To investigate the corrdativity of radiographic electrode location in fight ventricu- lar outflow pacing and characteristics of corresponding ECG, so to provide clinic benefit for determination of pacing lead position. Methods 98 cases with sinus node dysfunction or atrioventricular block patients of past 5 years were enrolled. All patients were implanted DDD-mode pacemaker with active fixation screw electrode in right ven- tricular outflow. According to different location in ventricular septal pacing, enrolled patients were divided into three groups ：high, middle and low pacing group. Several characteristics of 12 lead ECG were estimated including QRS wave morphology, duration and amplitude. Results In total 98 patients fits the pacemaker implantation eri- tefion, QRS wave duration was shortest（ 139±21 ）ms in middle septal pacing group. There were statistics significant differences compared with the high pacing group. The ascend of septal pacing electrode position, the anterior R/S wave transition in preeordial leads. Inferior lead R wave amplitude was correlated with the outflow septum pacing position. Conclusion ECG analysis can offer practical application in lead location of ventricular outflow septal pacing.

关 键 词：流出道起搏 室间隔起搏 心电图 

分 类 号：R541.7[医药卫生—心血管疾病]