20例预激综合征伴心房颤动患者心电图分析

Analysis of electrocardiogram in 20 patients of Wolff-Parkinson-White syndrome complicated with atrial fibrillation

目的研究预激综合征（WPW）伴心房颤动（Af）的机制与室性心动过速（VT）的关系,提出正确诊断与及时治疗的方法。方法对20例WPW伴Af患者的心电图及临床治疗资料进行分析。结果 20例患者常规心电图均记录到窦性心律,显示典型预激图形。Af阵发性发作时QRS波呈快速增宽且宽窄不等,部分QRS波起始处可见到δ波,显示WPW伴Af。心室率170~230 bpm,其中11例为170~190 bpm,7例为190~210 bpm,2例为210~230 bpm。有8例患者记录到房室折返心动过速（AVRT）,其中6例为前向折返性,2例为逆向折返性。结论 WPW伴快速心室率的Af最严重的结果是演变成VT与心室颤动,最终导致患者死亡。所以对WPW伴快速心室率Af的患者应尽快尽早给予治疗,使Af时心室率减慢并转为窦性心律。

Objective To research relationship between mechanism of Wolff-Parkinson-White（WPW）syndrome complicated with atrial fibrillation（Af）and ventricular tachycardia（VT）, and to provide method for correct diagnosis and timely treatment. Methods Analysis was made on electrocardiogram and clinical treatment data in 20 WPW syndrome complicated with Af patients. Results All 20 patients had recorded sinus rhythm with typical pre-excitation graph shown by electrocardiogram. Complication of WPW syndrome and Af was shown as rapidly broadening and uneven QRS wave during Af onset, along with δ wave in some section start of QRS wave. The patients had hear rate ranged 170~230 bpm, there were 11 cases with 170~190 bpm, 7 cases with 190~210 bpm and 2 cases with 210~230 bpm. There were 8 cases with recorded atrioventricular reentrant tachycardia（AVRT）, along with 6 forward reentrant cases and 2 backward reentrant cases. Conclusion Complication of WPW syndrome and Af with rapid ventricular rate may lead to VT and ventricular fibrillation, and finally causes death. Therefore, early and quick treatment for WPW syndrome complicated wtih Af with rapid ventricular rate is necessary, so as to reduce ventricular rate in Af to sinus rhythm.