心电向量图结合心电图诊断左间隔支阻滞34例分析

Diagnosis on 34 cases of left septal fascicular block by the combination of vectorcardiogram and electrocardiogram performance

目的探讨左间隔支阻滞的心电向量图及心电图表现。方法选取心电向量图检查呈左间隔支阻滞表现的34例患者,对比分析心电向量图与心电图表现。结果34例符合心电向量图Nakaya标准的左间隔支阻滞者中,横面(H)最大QRS环向量在45°~67°者8例,向前向量占总面积(64.62±6.37)%;横面(H)最大QRS环向量在30°~44°者26例,向前向量占总面积(71.32±8.18)%。横面(H)起始右前12例(35.29%),起始右前时间平均为(11.88±1.14)ms;横面(H)起始左前22例(64.71%);横面(H)QRS环体均为逆钟向运行。34例对应的心电图中,15例V 1~V 3导联R/S>1(44.12%),15例V 1导联R/S>1(44.12%),31例V 2导联R/S>1(91.18%),33例V 3导联R/S>1(97.06%),RV 2>RV 6>1者31例(91.18%);Ⅰ导联无Q波33例(97.06%),V 5和V 6导联均无Q波27例(79.41%)。结论心电向量图诊断左间隔支阻滞简便易行,结合心电图诊断更能体现心电生理检查的优势。

Objective To investigate the performance of vectorcardiogram(VCG)and electrocardiogram(ECG)on left septal fascicular block(LSFB).Methods A total of 34 cases of VCG with LSFB in ECG examination were compared and analyzed.Results There were 34 cases of LSFB that meet the VCG diagram Nakaya stan-dard:In 8 cases,the maximum QRS loop vectors were from 45°-67°in the cross section(H),and the forward-vector occupied(64.62±6.37)%of the total area;in 26 cases,the maximum QRS loop vectors were from 30°-44°in the cross section(H),and the forward-vector occupied(71.32±8.18)%of the total area.In 12 cases,the cross sections(H)were oriented in the right-front side(35.29%)with time of(11.88±1.14)ms;in 22 cases,the cross section(H)were oriented in the left-front side(64.71%);all the QRS ring were operated in counterclockwise.Among the 34 cases of ECG,15 cases showed R/S>1 on V 1-V 3 lead(44.12%);15 cases showed R/S>1 on V 1 lead(44.12%);31 cases showed R/S>1 on V 2 lead(91.18%);33 cases showed R/S>1 on lead V 3(97.06%);31 cases showed RV 2>RV 6>1(91.18%);33 cases showed no Q wave on leadⅠ(97.06%),27 cases showed no Q waves on lead V 5 and V 6(79.41%).Conclusion The diagnosis of LSFB in VCG diagram is simple and easy.It shows better advantages in electrophysiological examination while combined VCG with ECG.