摘要
目的 探讨预激综合征对QRS中间向量的影响及临床意义。方法 选经导管射频消融术 (RFCA)治愈的显性预激综合征得 12 9例 ,根据旁路部位分 9组 ;左前壁 (LA)、左侧壁 (LL)、左后壁 (LP)、右前壁 (RA)、右侧壁 (RL)、右后壁 (RP)、右前间隔 (RAS)、右中间隔 (RMS)、左后间隔 (RPS) ,对比分析射频消融术前、后心电图。结果 ①与消融旁路后心电图对比 ,12 9例显性预激综合征均影响中间向量。②中间向量变化与旁路位置有关 :aVL(和Ⅰ )导联 ,aVF(和Ⅱ、Ⅲ )导联及V1导联中间向量改变与旁路部位有明显关系。③预激综合征影响QRS电轴 :LA、LL旁路出现心电轴右移 (P <0 .0 1) ;LP、RL、RP、RMS及RPS旁路出现心电轴左移 (右中间隔P <0 .0 5 ,余P <0 .0 1) ;RA、RAS旁路术前、术后心电轴无显著差异 (P >0 .0 5 )。④预激综合征影响横面移行区 :LA、LL、LP和RP、RPS及RMS旁路常使横面移行区右 (前 )移。⑤中间向量改变与预激向量有关 :aVL、Ⅰ、Ⅱ、aVF、Ⅲ、V1导联QRS波群中间向量的变化与预激向量方向基本一致 (P <0 .0 1)。结论 显性预激综合征影响QRS波群初始向量同时 ,影响中间向量 ,且中间向量改变与δ波方向基本相同 ;观察中间向量的改变将有助δ波不明显的预激综合征的诊断和定位。
Objective To discuss the influence of preexcatation syndrome on QRS middle vector and its clinical significance. Methods 129 patients with preexcitation syndrome were confirmed to be single accessory pathway(AP) by radiofrequency catheter ablation(RFCA) and divided into 9 groups according to AP site:LA,LL,LP,RA,RL,RP,RAS,RMS,RPS.The middle vector of QRS complex before and after ablation were analyzed. Results ①The middle vector changed in all patients compared with the ECG after ablation.②The change characteristics of the QRS complex middle vector depended upon AP sites.③Compared with the ECG after ablation,LA,LL AP showed right axis deviation(P< 0.01 );LP,RL,RP,RMS,RPS AP showed left axis deviation(RMS P<0.05,rest P<0.01).RA,RAS AP showed no significant axis deviation(P>05).④Manifested AP changed horizontal transition zone.There were significant differences among various AP sites(P<0.01).⑤The change trend of the QRS middle vector were concordant with the initial vector polarity in leads aVL?Ⅰ?Ⅱ?aVF?Ⅲ?V_1(P<0.01). Conclusion Manifested AP can change the QRS middle vector.The characteristics of the middle vector are related to the AP sites.The change trend of the QRS middle vector are concordant with the initial vector polarity in leads aVL?Ⅰ?Ⅱ?aVF?Ⅲ?V_1.To observe the changes of the middle vector helps to the diagnosis and localization of preexcitation syndrome without obvious δ wave.
出处
《中国心血管病研究》
CAS
2004年第10期768-771,共4页
Chinese Journal of Cardiovascular Research
关键词
预激综合征
心电描记
QRS中间向量
射频消融术
preexcitation syndrome
electrocardiography
QRS middle vector
radiofrequency ablation
