显性预激少见的心电图3例分析

Analysis of 3 cases of rare electrocardiographic manifestations of ventricular pre-excitation

目的 心室预激少见心电图表现。方法 报道1例间歇性预激并逆向型房室折返性心动过速(AAVRT)及2例完全性心室预激。结果 例1患者男性,18岁。因反复阵发性心悸胸闷2月入院。心电图提示逆向型房室折返性心动过速。例2患者男性,56岁。因血便5天入院。心电图提示完全性右束支阻滞,房性早搏伴完全性心室预激。例3患者男性,35岁。因高处坠落致脑外伤5小时入院。入院心电图提示完全性心室预激;一度房室阻滞。多次观察心电图见“δ”波逐渐变小,2周后复查心电图“δ”波明显变小,QRS宽度明显变窄。结论 心电图在诊断预激综合征中有重要作用。

Objective Electrocardiographic manifestations of ventricular pre-excitation are rare. Methods One case of intermittent pre-excitation and retrograde atrioventricular reentrant tachycardia(AAVRT) and two cases of complete ventricular pre-excitation were reported. Results Case 1 was male, 18 years old. He was admitted to hospital for 2 months due to repeated paroxysmal palpitations and chest tightness. The electrocardiogram showed a retrograde atrioventricular reentrant tachycardia. Patient 2 was a 56-year-old male. He was admitted to hospital for 5 days with bloody stools. The electrocardiogram showed complete right bundle branch block, atrial premature beats with complete ventricular pre-excitation. Case 3 was a 35-year-old male patient. He was admitted to the hospital for 5 hours due to traumatic brain injury caused by a fall from a height. Admission ECG showed complete ventricular pre-excitation;first degree atrioventricular block. Repeated observation of the ECG showed that the "δ" gradually became smaller. After2 weeks, the "δ" wave of the ECG was re-examined significantly, and the QRS width was significantly narrowed.Conclusions ECG plays an important role in the diagnosis of pre-excitation syndrome.