预激综合征的心电图误诊分析

The investigation for patients with preexcitation syndrome who were misdiagnosed by electrocardiogram

目的探讨预激综合征(WPW)误诊的原因。方法选择发生误诊的WPW患者65例作回顾性的心电图特征分析。结果发生误诊的WPW中A型40例、B型25例,基础心律P波消失者20例。因QRS波群波形变化发生误诊37例,因继发性ST-T改变而发生误诊23例,存在房性早搏时发生误诊5例。结论 A型较B型WPW易发生误诊,WPW所致QRS波群变化是误诊的最常见原因,尤其在P波消失的情况下。

Objective To investigate the reason for misdiagnosis in patients with preexcitation syndrome.Methods The electrocardiogram characteristic were investigated retrospectively in 65 patients with preexcitation syndrome who were misdiagnosed as other disease.Results Among 65 patients,40 patients affected with type A preexcitation syndrome,25 patients affected with type B preexcitation syndrome.P waves were not found in 20 patients.37 patients were misdiagnosed because of the morphological changes of QRS,23 patients were misdiagnosed because of the secondary changes in ST-T,and 5 patients with atrial extrasystole were Misdiagnosed.Conclusion Comparing with type B preexcitation syndrome ,type A preexcitation syndrome is prone to be misdiagnosed.The morphological changes of QRS due to ventricular preexcitation may be the principal reason,particularly in those patients whose P waves are inexistent.