频发室性早搏起源分布特点及体表心电图特征分析  

Characteristics of origin distribution and surface electrocardiogram of frequent premature ventricular contractions

作　　者：吴肇贵[1] 黄从新[1] 徐斯驰 吴一芳 谭娅[1] 

机构地区：[1]武汉大学人民医院心内科,武汉大学心血管病研究所,心血管病湖北省重点实验室,武汉市430060

出　　处：《广西医学》2016年第11期1489-1491,共3页Guangxi Medical Journal

基　　金：“十二五”国家科技支撑计划项目(2011BAI11B12)

摘　　要：目的探讨频发室性早搏(PVCs)起源分布特点及体表12导联心电图特征。方法回顾性分析319例接受射频消融手术频发PVCs患者的临床资料,对射频消融术中标测的PVCs起源位置及体表12导联心电图等进行分析。结果 319例患者中,PVCs以起源于右室为主(72.73%),其次为起源于左室(25.39%),其中右室流出道起源者占右室起源者的91.81%,而左室起源部位相对分散,无明显优势起源部位。右室起源者、左室起源者分别以女性(62.50%)、男性(65.43%)居多。不同起源部位PVCs者的体表心电图具有不同特点,主动脉窦起源的PVCs与右室流出道起源PVCs者体表心电图相似。结论频发PVCs患者中,右室起源多于左室,心外膜及冠状窦口起源的PVCs较少见。不同起源部位PVCs的患者具有不同的体表心电图特点,以主动脉窦起源PVCs与右室流出道起源PVCs的体表心电图最难鉴别。Objective To explore the characteristics of origin distribution and 12-lead surface electrocardiogram（ECG） of frequent premature ventrieular contractions（PVCs）. Methods The clinical data of 319 patients with frequent PVCs receiving radiofrequency ablation were retrospectively analyzed. The origin location of PVCs and 12-lead surface ECG measured during radiofrequency ablation were analyzed. Results In 319 patients, PVCs mainly originated from the right ventricle （72.73%）, secondarily from left ventricle （25.39%）. And the origins of PVCs from right ventricular outflow tract（RVOT） accounted for 91.81% of the origins of PVCs from the right ventricle. But the origin of the left ventricle was relatively distributed and obtained no obvious superior site. The cases originated from the right ventricle and left ventricle were common in the female（62.50% ） and the male（65.43% ） respectively. The characteristics of surface ECG were different among patients with different origins of PVCs. The characteristics of surface ECG in the patients with PVCs origins from the aortic sinus cusp （ASC） were similar to those in the patients with PVCs origins from the RVOT. Conclusion In the patients with frequent PVCs,thc origins of PVCs from right ventricle are more common than those from left ventricle,and PVCs originated from epicardium and coronary sinus orifice are rare. The characteristics of surface ECG are different among patients with different origins of PVCs,and it is difficult to differentiate the surface ECG between PVCs from ASC and RVOT.

关 键 词：室性早搏 电生理学 室性早搏起源 心电图 射频消融术 

分 类 号：R541.7[医药卫生—心血管疾病]