心房复极波增大诱发异位心房激动的临床分析

Ectopic atrial impulse caused by exaggerated atrial repolarization waves

目的观察心房复极波增大诱发异位心房激动的临床和心电图特征。方法对7例心房复极波间歇性增大致PR段及ST段同步下移并诱发房性早搏及心房扑动的临床表现和常规心电图特征进行分析。结果出现这一心电现象的导联广泛，以V3、V4导联显著，房性早搏及心房扑动的配对问期短且固定，而配对间期较长的房性早搏则无PR段及ST段下移。患者存在心脑肺结构破坏及功能损害或低钾血症，病情好转时上述现象减轻或消失。结论在病理条件下心房复极波增大致心房复极离散度增大，提示心电活动不稳定，易于诱发折返性异位心房激动。

Objective To observe the feature of clinical and electrocardiogram（ECG） in ectopic atrial impulse which is caused by exaggerated atrial repolarization. Methods Clinical appearance and the ECG feature of download P-R segment and ST segment caused by exaggerated atrial repolarization wave and leading premature atrial contraction（PAC） and atrial flutter were analyzed in 7 cases. Results The exaggerated atrial repolarization waves were observed in multiple leads especially in V3 and V4. The coupling interval of PAC and atrial flutter was short and fixed, while no such patterns could be seen in the PAC with longer coupling interval. Patients were suffered from heart,lungs and brain diseases or hypopotassaemia. The ECG changes weakened or disappeared when the patients＇ conditions improved. Conclusion With the illness, the rise of the atrial repolarization dispersion,caused atrial electric activity unstable and leads reentrant atrial impulse easily.