单向房室阻滞心电图分析及临床意义

Electrocardiogram analysis and clinical significance of the unidirectional atrioventricular block

目的 探讨单向性房室阻滞心电图特征、发生机制及临床意义.方法 对12例符合单向性房室阻滞特征的心电图资料进行分析.结果 12例完全性房室阻滞患者的逸搏起搏点包括房室交接区7例,心室5例,逸搏QRS波之后间断性跟随P波,R-P变动在0.12～0.40 s（平均0.19±0.07s）,2例形成房性融合波,1例伴随心室回波.12例患者的临床转归包括安装心脏起搏器10例,死亡1例,放弃治疗1例.结论 心电图确诊单向性房室阻滞,对起搏方式选择和预防安装起搏器后可能引起的并发症有一定指导意义。

Objective To explore Electrocardiogram（ECG） characterristics mechanism and clinical significance of unidirectional atrioventricular block （A-VB）. Methods ECGs were analyzed in 12 patients with unidirectional A-VB. Results In 12 patients of complete A-VB, 7 patients manifested as junctional escape rhythm and 5 manifested as ventricular escape rhythm.QRS wave of escape beat followed by retrograde P （P） intermittently, R-P interval changed in the scope of 0.12-0.40s （average 0.09 ± 0.07s）. 2 patients showed atrial fusion beat,and one of them followed by ventricular echo beat. About 12 patients＇ clinical outcome,10 patients installed pacemaker,1 died and lgiven up treatment. Conclusions Unidirection A-VB on ECG is of guiding value for determining pacing mode and avoiding eomphcations.