老年男性心室流出道室性早搏的临床特点及与冠心病的关系

ECG characteristics of ventricular premature beat originated from the outflow tract and their relation with coronary artery disease

目的探讨老年男性频发流出道室性早搏心电图特征及与冠心病的关系。方法回顾性分析111例检出频发室性早搏患者的24h动态心电图,分析起源于心室流出道室性早搏的QRS波群特征及所占比例。结果111例频发室性早搏中45例起源于心室流出道,41例为非流出道起源,25例为频发多源室性早搏,流出道室性早搏患者冠心病发生率明显低于其他两组(P<0.05)。结论部分老年男性室性早搏起源于心室流出道,其电生理特性与普通心肌细胞不同,具有明显的自律性和电生理各向异性,起源于心室流出道的室性早搏与心肌缺血无相关性。

Objective To study the ECG characteristics of frequent premature ventricular beat （PVB） originated from ventricular outflow tract （VOT） and their relation with coronary artery disease. Methods Twenty four–hour dynamic ECG of 111 senile patients with frequent PVB originated from VOT and characteristics of their QRS complex were retrospectively analyzed with the proportion of QRS complex calculated. Results Of the 111 senile patients with frequent PVB, 45, 41 and 25 were originated from VOT, non- VOT, and multiple sites, respectively. The incidence rate of coronary artery disease was significantly lower in patients with PVB originated from VOT than in patients with PVB originated from non-outflow tract. Conclusion The electrophysiological characteristics of male senile patients with PVB partially originated from VOT are different from those of general myocardial cells with a clear automaticity and an electrophysiological anisotropy. PVB originated from VOT is not related with myocardial ischemia.