心室起搏Lorenz-RR散点图近端曲尺状图形揭示的电生理机制  

Electrophysiological mechanisms revealed by proximal caliper-shaped patterns in Lorenz-RR scatter plot of ventricular pacing

作　　者：戴静[1] 李则林[2] 龙佑玲[1] 毕艳芳 王娅 孙沁雪 DAI Jing;LI Zelin;LONG Youling;BI Yanfang;WANG Ya;SUN Qinxue(Department of Electrophysiology,Kunming Municipal Hospital of Traditional Chinese Medicine,Kunming Yunnan 650051;Department of Special Inspection,Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou Zhejiang 310003;the First Clinical College,Kunming Medical University,Kunming Yunnan 650500,China)

机构地区：[1]昆明市中医医院电生理科,云南昆明650051 [2]浙江省中西医结合医院特检科,浙江杭州310003 [3]昆明医科大学第一临床学院,云南昆明650500

出　　处：《实用心电学杂志》2023年第5期349-354,共6页Journal of Practical Electrocardiology

基　　金：昆明市卫生科技人才培养项目暨心电向量技术诊断中心建设项目[2020-SW(技)-0012]。

摘　　要：动态心电图中起搏Lorenz-RR散点图的不同表现,有助于判断起搏心电图的性质。心室起搏Lorenz-RR散点图45°线上近端呈曲尺状图形,揭示出散点图特征背后的电生理机制:起搏器上限跟踪频率(upper tracking rate,UTR)行为,即起搏器设置的UTR和(或)UTR限制导致的起搏器文氏现象,提示患者植入的起搏器为跟踪模式。本文选取了2例在心室起搏Lorenz-RR散点图近端45°线上呈曲尺状的图形,通过逆向分析其动态心电图的不同表现,识别起搏器相关的现代功能运作,从而明确起搏器品牌、判断起搏器功能。The different manifestations of pacing Lorenz-RR scatter plot in ambulatory electrocardiography(AECG)help to judge the property of the pacing electrocardiogram(ECG).The caliper-shaped pattern proximal to the 45°line of the Lorenz-RR scatter plot of ventricular pacing reveals the electrophysiological mechanisms behind the scatter plot characteristics.The Wenckebach phenomenon caused by the behavior of the pacemakers upper tracking rate(UTR),that is,the UTR set by pacemaker and(or)limitations of UTR,indicates that the implanted pacemaker has been working in a tracking mode.This paper selects two cases with caliper-shaped patterns proximal to the 45°line of the Lorenz-RR scatter plot of ventricular pacing,analyzes different manifestations of AECG by reverse analysis technique,and identifies the operation of modern functions related to pacemakers,so as to clarify the brand and functions of pacemakers.

关 键 词：心室起搏 Lorenz-RR散点图 起搏心电图 电生理机制 

分 类 号：R540.41[医药卫生—心血管疾病]