摘要
对射频消蚀治疗成功的37例左室特发性室性心动过速(室速)病人的室速时心电图QRS电轴与消蚀成功的室速起源部位之间的关系进行分析,发现室速起源部位绝大多数分布在左室中隔部,心动过速时额面QRS电轴范围为-50°~-115°。以额面QRS电轴-76°~-100°判断室速起源部位位于左室后中隔中1/3部,阳性预测值为90.9%,阴性预测值为80.0%。当电轴更偏,小于-100°时,室速起源部位则偏向于心尖部;而电轴大于-76°,电轴左偏程度偏小时,起源部位则偏向于基底部。1例室速起源部位在左室前侧游离壁者,心动过速时电轴为右偏。
Idiopathicleftventriculartachycardia(ILVT)originatesfrequentlyfromtheseptalofleftventricleandhasQRSmorphologyasrightbundlebranchblockandleftaxisdeviation.Thedevi-ationdegreeofQRSaxisinfrontalplaneisdiferentaccordingtothesiteoforiginpreciselydeter-minedbyendocardialcathetermappingandradiofrequencyablation.Outofthe37patientswithIL-VT,23casesoriginateatthemiddlethirdofposteroseptalofventricle,QRSaxisrangefrom-76°to-100°.Thisfindinghasthesensitivityof86.9%(20/23),specificityof85.7%(12/14),positivepredictivevalueof90.9%(20/22)andnegativepredictivevalueof80%(12/15).WhentheQRSaxiswasmorethan-100°,theoriginofILVTwasneartheapex,whereasitwasnearthebasewhenlesthan-76°.ThedegreeofQRSaxis-76°to-100°inILVTmayhelpinlocalizingtheinitialmappingsiteofLIVTwhichwouldshortenthemappingtimeduringradiofrequencyablationofIL-VT.
出处
《中华心血管病杂志》
CSCD
北大核心
1996年第1期28-30,共3页
Chinese Journal of Cardiology
关键词
心动过速
心电描记术
QRS电轴
射频消蚀术
tachycardia
paroxysmalelectrocardiographyQRSaxisablation
radiofrequency