完全性房室阻滞伴双重及多重逸搏心律的心电图分析

Analysis on electrocerdiogram and clinical significance of complete atrioventricular block companied by double and multiple escape rhythms

目的探讨完全性房室阻滞伴双重及多重逸搏心律的心电图改变及其临床意义。方法通过常规心电图对10例完全性房室阻滞伴双重及多重逸搏心律患者的心电图资料进行回顾性分析。结果分析心电图表明:①3例逸搏心律分别起源于房室交界区及心室两个部位,逸搏QRS波呈宽、窄交替;②3例逸搏心律分别起源于左、右心室,交替出现左、右束支阻滞形逸搏QRS波;③3例心房颤动伴完全性房室阻滞,逸搏心律分别起源于左、右心室,交替出现左、右束支阻滞型的逸搏QRS波;④1例表现为两个以上起源部位的逸搏,可见多种形态逸搏QRS波;⑤5例伴不同程度室性融合波,出现中间形态的QRS波。结论确定双重及多重逸搏心律的心电图诊断,对估计阻滞病变的性质及部位有重要的参考价值。

Objective To investigate the electrocardiogram （ECG） changes and clinical significance of complete atrioventricular block（AVB） accompanied by double and multiple escape rhythms. Methods Ten patients with ECGs demonstrating as complete AVB and double or multiple escape rhythms. Results ①Three patients＇ ECG take on a phenomenon of alternative broad and narrow QRS wave whose escape rhythms come from atrioventricular junctional area and ventricular reversely; ②The other three take on a phenomenon of alternative left and right bundle branch block, whose escape rhythm come from left and right ventricular reversely; ③The other three have atrial fibrilliation along with complete atrioventricular block, alternative left and right bundle branch block with right and left ventricular as the escape origins were found; ④One patient with two kinds of escape QRS waves for there are more than 2 escape origins; ⑤Five patients have different ventricular fusion beat, which lead to medial QRS waves. Conclusions To establish a diagnosis of double or multiple escape rhythms is of much reference importance to tell the block area and its nature.