应用叠加图快速分析动态心电图  

Rapid analysis of ambulatory electrocardiography with superposition diagram

作　　者：王秀芳 申继红[2] 景永明[2] 李世锋[2] WANG Xiufang;SHEN Jihong;JING Yongming;LI Shifeng(Department of Electrocardiogram,Tianshui City Hospital of Integrated Traditional Chinese and Western Medicine,Tianshui Gansu 741020;Department of Electrocardiogram,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou Henan 450014,China)

机构地区：[1]天水市中西医结合医院心电图科,甘肃天水741020 [2]郑州大学第二附属医院心电图科,河南郑州450014

出　　处：《实用心电学杂志》2024年第6期588-594,共7页Journal of Practical Electrocardiology

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220435)。

摘　　要：目的探讨叠加图的原理及其在动态心电图分析中的应用。方法选择4例与形态信息有关的典型动态心电图病例(窦性心律+室性心律、窦性心律+房性心律、窦性心律+交界性心律、双腔起搏器DDD工作方式+VAT工作方式),结合Lorenz散点图、心电瀑布图、逆向技术分析并总结叠加图的原理及优势。结果室性心律呈宽QRS波形态,而窦性心律呈窄QRS波形态,通过叠加图可实现两种节律的快速分离;窦性心律P波直立,而房性心律P波倒置,通过叠加图可实现两种节律的快速分离;窦性心律P波直立,而交界性心律无P波,通过叠加图可实现两种节律的快速分离;双腔起搏器DDD工作方式下可见AP及VP双脉冲,而VAT工作方式下可见VP单脉冲,通过叠加图可实现两种起搏方式的快速分离。结论叠加图在分析包含形态信息变化的动态心电图中有独特优势,是快速分析动态心电图的另一高效工具。Objective To explore the principle of superposition diagram and its application in the analysis of ambulatory electrocardiography(AECG).Methods We selected 4 typical AECG cases related to morphological information(sinus rhythm and ventricular rhythm,sinus rhythm and atrial rhythm,sinus rhythm and junctional rhythm,DDD pacing mode and VAT pacing mode of dual-chamber pacemaker).The principle and advantages of superposition diagram were analyzed,and summarized in combination with Lorenz scattered plot,ECG waterfall diagram and reverse technique.Results Ventricular rhythm showed a wide QRS complex pattern,while sinus rhythm was manifested by a narrow QRS complex pattern;the above two rhythms could be separated rapidly by superposition diagram.The sinus rhythm showed upright P-wave,while atrial rhythm showed inverted P-wave;the above two rhythms could be quickly separated by superposition diagram.The sinus rhythm showed upright P-wave,while the junctional rhythm showed no P-wave;the above two rhythms could be separated quickly by superposition diagram.In the DDD pacing mode of dual-chamber pacemaker,the double pulses of AP and VP could be observed,while the single pulse of VP appeared in the VAT pacing mode;the two kinds of pacing modes could be quickly separated by superposition diagram.Conclusion The superposition diagram has unique advantages in the analysis of AECGs with morphological information changes,and it is another efficient tool for rapid analysis of AECGs.

关 键 词：动态心电图 叠加图 窦性心律 室性心律 房性心律 交界性心律 起搏方式 

分 类 号：R540.4[医药卫生—心血管疾病]