WPW征伴房性早搏的心电图表现形式

Electrocardiogram manifestations of WPW with atrial premature beat

目的探讨WPW征伴房性早搏的心电图表现形式。方法回顾性分析常规心电图及动态心电图中的WPW征伴房性早搏77例。结果发现WPW征伴房性早搏的8种心电图表现形式:(1)房早之预激波增大甚或呈完全性预激;(2)房早之预激波减小甚或消失;(3)房早之预激波不变;(4)窦性心搏正常仅房早呈现WPW征;(5)房早揭示隐匿性WPW征并诱发AVRT;(6)房早之室内差异传导被WPW征掩盖;(7)房早伴1:2房室传导并诱发AVRT;(8)房早伴发旁道与正道间的蝉联现象。结论 WPW征伴房早的心电图表现形式极具多样性、易变性和误导性。可使心电图表现复杂化,从而增加了正确分析及诊断的难度。认识其变化规律及心电图特点,可提高实际工作中对这类心律失常心电图的诊断及鉴别诊断能力,减少或避免误诊及漏诊的发生。

Objective To investigate the electrocardiogram manifestation of WPW with atrial premature beat(AP). Methods 77 cases of WPW sign with atrial premature in routine electrocardiogram and dynanic electrocardiogram were analyzed retrospectively. Results WPW sign with AP was found in 8 ECG manifestations:(1) AP preexcitation wave increased or even complete preexcitation;(2) AP preexcitation wave decreases or even disappears;(3) AP preexcitation wave unchanged;(4) sinus normal heart beat only AP presented WPW sign;(5) AP reveals latent WPW sign and induces AVRT;(6)indoor differential conduction of AP is covered by WPW sign;(7)AP with l:2 atrioventricular conduction and induced AVRT;(8)AP is accompanied by the side of the road and the way of win ni ng again and again. Conclusions The electrocardiogram manifestations of WPW with AP are very diverse,variable and misleading. It may complicate the electrocardiogram performance and thus increase the difficulty of corret analysis and diagnosis Understanding the change rules and characteristics of ecg can improve the ability of diagnosis and differential diagnosis of ecg for this kind of arrhythmia in practice, and reduce or avoid the occurrence of misdiagnosis and missed diagnosis.