体表窦房结电图对房性心律失常诊断价值的探讨

The Value of Body Surface Sinus Node Electrogram(SNEb)in the Diagnosis Atrial Arrhythmia

对438例疑有心律失常考，采用超微心电图仪同步实时描记体表窦房结电图（SNEb）、ECGⅢ或／及αVR，检测毕记录9或12导心电图。结果检出房住心律失常59例。其中SNEb与ECG均能确诊并结果相同者47例，占检出率的79．7％。SNEb能确诊而ECG难以确诊和易误诊或漏诊者12例，占检出率的203％。

438 patients with arrhythmia (280 male, 158 female, 3~ 81 years old), were synchronously recorded with the SNEb ahd lead Ⅱ and αVR of ECG in this study. Each patient was recorded by 9 or 12 leads of ECG after above exandnation. Among 59 patients with atrial arrhythnda,47 got the same diagnosis by SNEb and ECG,while 12 only by SNEb and not by ECG. The features of these 12 ndsdiagnosed patients in ECG were as follows:1.Nonconduction atrial premature beat in 3 patients was ndsdiagnosed as sinus arrhythmia.2. Atrial premature beat in 2 patients and reciprocal beat in 1 which were ndsdiagnosed as A-V junctional pre-mature beat.3. Multifocal atrial tachycardia in 1 patient and short paroxysmal atrial tachycardia in 4 patients which were misdiagnosed as shifting pacemaker within sinus node or sinus Prrythfora.4. Isolated atrial flutter in 1 patient was misdiagnosed as sinus bradycardia.The resu1ts showed that the sNEb could really renect electrical activity of sinus node,the origin and transmis-sion of atrial impulse when special amplifier,higher gain and extraordinary lead were used. SNEb is much betterthan the ECG to diagnose the atrial arrhythmia in the susceptibility and accuracy.