9例酷似各类房室阻滞心电图分析

Analysis of Very Much Resembling to Atrioventricular Block in 9 Cases of Electrocardiogram

目的通过对房室阻滞诊断中应注意问题的分析,进一步认识一些心律失常中常见的心电现象对房室阻滞诊断的影响,明确房室阻滞的诊断标准。方法回顾性分析9例酷似各类房室阻滞的心电图资料,除外双径路、隐匿传导、干扰等的影响进行再分析。结果经正确性评定,2例为房室结双径路;2例窦性心律过缓合并不完全性干扰性房室分离;3例3∶2文氏周期合并逸搏干扰;1例顿锉型3∶2二度Ⅰ型房室阻滞合并隐匿性传导;1例二度2∶1房室阻滞合并干扰性房室分离。结论各类房室阻滞的诊断须除外干扰、分层阻滞、隐匿性传导、双径路等心电现象的影响;三度房室阻滞也不能仅以"房室分离且房率快于室率"作为诊断标准,还应辅以"心室率<50bpm;心房率<135bpm;RR间期>2倍的PP间期"。

Objective To analyze the problems that should notice in diagnosis of atrioventricular block, get further knowledge of the effect of atrioventricular block in some common ECG phenomena in arrhythmla, define the diagnostic criteria of atrioventricular block. Methods Review 9 cases ECG data very much resembling to atrioventricular block,except effect of dual pathways,concealed conduction, interference etc. Results Through correctness studying,there are 2 cases of 9 that were diagnosed as dual atrioventricular nodal pathways, 2 cases of as Sinus bradycardia combine incomplete and interference AV dissociation , 3 cases of 3：2 Wenckbach with interference of es- cape beats, 1 case of as abortive type combine 3：2 the second degree and one type atrioventriculax block with concealed conduction, 1 case of as the second degree 2：1 atrioventricular block with interference atrioventricular dissociation. Conclusions Diagnosis of the atrioventricular blocks must eliminate effect of ECG phenomena such as interference, delamination block, concealed conduction,dual pathways. The third degree atrioventricular block can＇ t diagnose only with atrioventricular dissociation and faster atria rate than ventricle rate but also should be supplement with ventricle rate 〈50bpm, atria rate 〈 135bpm and RR interval is longer than the twice PP interval as for diagnostic criteria of complete atrioventricular block.