无人区电轴对心房颤动伴宽QRS波群的临床价值

Value of the electrocardiogram of "No Man's Land" in atrial fibrillation complicated with wide QRS wave

目的探讨无人区电轴对心房颤动伴宽QRS波群的临床意义。方法对113例心房颤动伴宽QRS波群心电图患者,用常用方法鉴别诊断为心房颤动伴室早、室速或心房颤动伴室内差异传导。经心电图Ⅰ、avF导联目测心电轴。结果113例患者中52例为心房颤动伴室早或室速,其中17例心电轴位于无人区,61例为心房颤动伴室内差异传导,且无一例心电轴位于无人区。无人区电轴诊断心房颤动伴室早或室速的特异性达100%,敏感性32.69%。结论无人区电轴可作为心房颤动伴室早、室速或室内差异传导诊断及鉴别诊断的重要指标,特异性很高,但敏感性较低。

Objective To explore clinical significance of axis of ＂no man＇ s land＂ for patients with atrial fibrillation（AF）eomplicated with wide QRS. Methods 113 patients with AF complicated with wide QRS wave were included in tiffs study. Twelve - lead electrocardiogram （ECG） or dynamic ECG were available in all patients, and measured lead I ,aVF QRS electric axis visually. Results There were 52 patients with ventricular premature heats or ventrieular tachyeardia, 17 patients with axis of ＂no man＇ s land＂ among them. There were 61 patients with aberration, no one was axis of ＂no man＇ s land＂ among them. The sensitivity and specificity of the axis in ＂no man＇ s land＂ was 32.69% and 100%, respectively. Conclusion The axis of ＂no man＇ s land＂ can be an important index in the differential diagnosis of vcntrieular arhythmia and aberration for wide QRS in the patients with atrial fibrillation.