心电向量图对左前分支阻滞合并陈旧性下壁心肌梗死的诊断优势

The advantages of vectorcardiogram in diagnosing left anterior fascicular block complicating old inferior wall myocardial infarction

目的探讨心电向量图在左前分支阻滞(left anterior fascicular block,LAFB)合并陈旧性下壁心肌梗死诊断方面的优势。方法釆集并分析两例有代表性的LAFB合并陈旧性下壁心肌梗死患者的心电图和心电向量图。心电图和心电向量图分别用Wilson导联体系和Frank导联体系采集。结果心电图无法明确诊断LAFB合并陈旧性下壁心肌梗死。而心电向量图的特征性表现为额面起始向量位于下方偏左或右,然后迅速转向左上,环体向左上展开;离心支呈顺钟向运行,归心支位于离心支的上方,呈逆钟向运行。结论心电向量图诊断LAFB合并陈旧性下壁心肌梗死明显优于心电图。

Objective To explore the advantages of vectorcardiogram( VCG) in diagnosing left anterior fascicular block( LAFB) complicating old inferior wall myocardial infarction. Methods ECG and VCG of two typical patients with LAFB complicating old inferior wall myocardial infarction were collected and analyzed. Wilson and Frank lead systems were utilized in collecting ECG and VCG,respectively. Results ECG can not lead to definitive diagnosis of LAFB. VCG showed distinctive manifestations. Frontal initial vector on VCG was located on the left or right at the bottom and then quickly turned to upper left,and the ring also developed to the upper left; the centrifugal limb ran in clockwise direction while the above afferent limb ran in counterclockwise direction. Conclusion VCG proves to be obviously superior to ECG in diagnosing LAFB complicating old inferior wall MI.