致心律失常性右心室心肌病与特发性右心室流出道室性心律失常的心电图比较  

Comparison of electrocardiographic features of ventricular arrhythmias from the arrhythmogenic right ventricular cardiomyopathy and idiopathic right ventricular outflow tract arrhythmias

作　　者：任岚[1] 韩昊[1] 贾玉和 郑梅[1] 赵颖[1] 孙华毅[1] 刘巍 张澍[2] REN Lan;HAN Hao;JIA Yuhe;ZHENG Mei;ZHAO Ying;SUN Huayi;LIU Wei;ZHANG Shu(Department of Cardiology,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院心内科,100035 [2]中国医学科学院北京协和医学院国家心血管病中心阜外医院

出　　处：《心肺血管病杂志》2022年第6期615-620,共6页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:左束支传导阻滞伴电轴向下的室性心律失常可出现于致心律失常性右心室心肌病(ARVC)和特发性右心室流出道起源的室性心律失常(RVOT-IVAs)。回顾性比较两种基质下心电图的不同。方法:入选16例ARVC和45例RVOT-IVA患者,对静息窦性心律心电图及室性心律失常发作心电图参数及特征进行测量比较。结果 :窦性心律下,ARVC组Epsilon波,胸前导联及下壁导联T波倒置的发生率更高。室性心律失常发作图中,ARVC组QRS波时程更长,其中I导联差异最大(25.1±5.8)ms。ARVC组胸前导联移行≥V5发生率较高(37.5%vs. 8.9%, P<0.01)。宽顿挫QRS出现于侧壁导联(I导联和aVL导联)在ARVC组中更常见(43.8%vs.13.3%, P=0.011)。结论 :较长的QRS波时程,胸前区移行较晚及侧壁导联出现宽QRS顿挫可用于鉴别ARVC及RVOT-IVAs。Objective: To analyze the electrocardiographic differences of Ventricular arrhythmias with left bundle branch block(LBBB)/inferior axis origin from arrhythmogenic right ventricular cardiomyopathy(ARVC) and idiopathic right ventricular outflow tract ventricular arrhythmias(RVOTIVAs). Methods: Electrocardiographic(ECG) of sinus rhythm and VA episode of 16 ARVC and 45RVOT-IVAs were collected and compared. Results: The phenomenon of epsilon wave and T wave inversion(TWI) were significantly more frequent in ARVC. Compared with ventricular arrhythmia of RVOT-IVAs,ARVC had longer QRS duration in all 12 leads. The mean difference was largest in Lead Ⅰ(25.1±5.8ms).ARVC had more R wave transition in lead V5 or later(37.5% vs. 8.9%, P<0.01) and wide notched QRS in lateral leads(43.8% vs.13.3%, P=0.011). Conclusion: Longer QRS duration, later precordial R/S transition and wide notched QRS in lateral leads(leadⅠand aVL) showed value in discriminating ARVC from RVOTIVAs.

关 键 词：致心律失常性右心室心肌病 室性心律失常 心电图 

分 类 号：R54[医药卫生—心血管疾病]