早搏揭示位相型束支阻滞的心电图分析

The Electrocardiogram analysis about premature beat revealing phase-based bundle branch block

目的探讨早搏对位相型束支阻滞的揭示作用和诊断价值。方法利用早搏的回归周期明显长于基础周期这一特征,对17例患者早搏后第1次窦性搏动形态改变进行分析,间接诊断位相型束支阻滞,并确定其类型。结果 17例患者早搏后的QRS形态均发生改变,依据位相型束支阻滞诊断标准,共发现3相右束支阻滞8例、3相左束支阻滞5例、3相左前分支阻滞1例、4相右束支阻滞1例、4相左束支阻滞2例。结论位相型束支阻滞多呈一过性改变,较难扑捉,借助于早搏后回转周期长于基础窦性周期来间接诊断是一种简洁、可靠的方法,无疑对基础疾病的预后判断以及对心律失常机制的理解是十分有益的。

Objective To Discuss premature beat＇s diagnostic value and the role to reveal phase-based bundle branch block.Methods Using the feature that premature beat＇s regression cycle is significantly longer than the basic cycle.To analye 17cases of patients with first sinus best＇s morphological change after premature beat to get an indirectly diagnosis about phase-based bundle branch block and confirm its type.Results All the 17patients＇s QRS form changed after premature beat.According to the diagnostic criteria of the phase-based bundle branch block,we found a total of 3 phase-based block of right bundle branch 8 cases,3 phase-based block of left bundle branch 5 cases,3 phase-based block of left anterior bundle branch 1cases,4 phase-based block of right bundle branch 1 cases,4 phase-based block of left bundle branch 2 cases.Conclusions The change of phase-based bundle branch block is transient,which is hard to observe,the method is simple and reliable using the feature that vegression cycle after premature beat is longer than the basic sinus cycle,which is undoubtedly very useful to judge the prognosis of basic diseases and understand the mechanism of arrhythm.