心房颤动时伴室性早搏和伴室内差异性传导的Lorenz-RR散点图特征  

Lorenz-RR scatter plot characteristics of atrial fibrillation with premature ventricular complex and aberrant ventricular conduction

作　　者：彭鼎 向晋涛[2] 黎秀莲 甘杰梅 张舒媚 PENG Ding;XiangJin-tao;LI Xiu-lian;GAN Jie-mei;ZHANG Shu-mei(The Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan People′s Hospital,Qingyuan 511500,Guangdong,China;Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]广州医科大学附属第六医院,清远市人民医院,广东清远511500 [2]武汉大学人民医院心内科,湖北武汉430060

出　　处：《中国心脏起搏与心电生理杂志》2024年第1期13-17,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：清远市社会发展领域自筹经费科技计划项目(200808164561451)。

摘　　要：目的探讨心房颤动(简称房颤)伴室性早搏(简称室早)或伴室内差异性传导(简称差传)的Lorenz-RR散点图(简称散点图)特征及差异。方法对2016年6月至2020年6月在清远市人民医院行动态心电图检查诊断为房颤伴室早的190例患者的散点图进行回顾性分析,另选择诊断为房颤伴差传的74例患者的散点图作为对照组,分别观察散点图图形特征。结果整体散点图特征,差传组全部74例均呈宽QRS波点集被完全覆盖的扇形;室早组共190例,其中有93例与差传组类似,有43例呈宽QRS波及其前点点集、房颤扇形各自分离的“三分布”特征,有54例呈宽QRS波点集近端插入到扇形区域内、远端与扇形区域分离的特征。局部散点图特征,差传组全部74例均呈宽QRS波点集沿房颤扇形边界区域分布的特征;室早组中与差传组有类似散点图的93例中,有59例仍与差传组表现类似,30例室早点集远离房颤扇形边界区域朝远端分布,4例室早点集散乱的广泛分布于减速区与等速线之间。结论房颤伴差传时散点图为单纯的扇形;而房颤伴室早时散点图可呈室早点集与室早前点集与扇形分离的三分布图形(大约70%),亦可呈单纯扇形(大约30%)。Objective To explore the characteristics and differences of Lorenz-RR scatter plots(scatter plots) of atrial fibrillation(AF) with premature ventricular complex(PVC) or with aberrant ventricular conduction(AVC).Method A retrospective analysis was conducted on the scatter plots of 190 patients diagnosed with AF and PVC through dynamic electrocardiogram examination at Qingyuan People′s Hospital from June 2016 to June 2020.Additionally,74 patients diagnosed with AF and AVC were selected as the control group,and the scatter plot characteristics were observed.Result The overall scatter plot features showed that all 74 cases in the control group had a wide QRS wave scatter set completely covered by the fan-shaped scatter set of AF;There were a total of 190 cases in the PVC group,of which 93 cases were similar to the control group.There were 43 cases with "three distribution" characteristics of wide QRS wave scatter set and its anterior point scatter set,and AF fan-shaped separation,while 54 cases with wide QRS wave scatter set wre characterized by proximal insertion into the fan-shaped area and distal separation from the fan-shaped area.Local scatter plot features,all 74 cases in the control group showed a wide QRS wave scatter set distributed along the fan-shaped boundary area of AF;Among the 93 cases in the PVC group that had scatter plots similar to those in the control group,59 cases still showed similar performance to the control group,30 cases of PVC scatter sets were distributed far away from the fan-shaped boundary area of AF towards the distal end,while 4 cases of PVC scatter sets were scattered and widely distributed between the deceleration zone and the isokinetic line.Conclusion The scatter plot of AF with VAC is a simple fan-shaped pattern;The scatter plot of AF accompanied by PVC can exhibit a three distribution pattern(approximately 70%)of separation of the scatter plot of PVCs,Scatter set of points in front of PVCs,and the scatter plot of fanshaped beats,or it can also exhibit a simple fan shaped patt

关 键 词：心血管病学 心律失常 心房颤动 室性早搏 室内差异性传导 心电散点图 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]