心电瀑布图诊断窦性心律合并竞争性心律失常的价值

Value of ECG waterfall chart in diagnosing sinus rhythm complicated by competitive arrhythmias

目的探讨心电瀑布图诊断窦性心律合并竞争性心律失常的价值。方法回顾性分析41例窦性心律合并竞争性心律失常的心电瀑布图的变化,并总结其特征。结果窦性心律时心电瀑布图持续稳定存在颜色一致的P、QRS、T峰带;竞争性心律失常发生时,P、QRS、T峰带的颜色会发生变化或出现P峰带的漂移。窦性心律合并房性自主心律的瀑布图特征:P峰带出现断裂,R、T峰带不变。窦性心律合并交界性自主心律的瀑布图特征:PR间期出现变化,P峰带出现断裂、漂移(甚至漂移至R峰带下方),R、T峰带不变。窦性心律合并室性自主心律的瀑布图特征:P、QRS、T峰带同步出现颜色变化。结论当竞争性心律失常与窦性心律交织在一起时,通过选择P-QRS-T波群变化比较明显的导联并观察心电瀑布图上P、QRS、T峰带的变化,可以准确掌握竞争性心律失常的发作时间和持续时间。

Objective To explore the value of electrocardiogram(ECG)waterfall chart in the analysis of sinus rhythm complicating competitive arrhythmias.Methods We retrospectively analyzed the changes of ECG waterfall charts of ambulatory electrocardiography among 41 patients with sinus rhythm complicating competitive arrhythmias,and summarized their characteristics.Results During sinus rhythm,ECG waterfall chart is continuously and stably manifested by P,QRS,and T peak bands with the same color.In the occurrence of competitive arrhythmias,the P,QRS and T peak bands change in color,or the P peak band drifts.The characteristics of the waterfall chart of sinus rhythm complicating atrial autonomic rhythm are as follows:P peak band is split while R and T peak bands remain the same.The characteristics of the waterfall chart of sinus rhythm complicating junctional autonomic rhythm are as follows:PR interval changes,P peak band splits and drifts(even drifting to the bottom of the R peak band)while the R and T peak bands remain unchanged.The characteristics of the waterfall chart of sinus rhythm complicating ventricular autonomic rhythm are as follows:P,QRS,and T peak bands synchronously change colors.Conclusion When competitive arrhythmias and sinus rhythm are intertwined together,we can accurately grasp the onset time and duration of competitive arrhythmias by selecting the lead with obvious changes of P-QRS-T complex,and observe the changes of P,QRS and T peak bands in the ECG waterfall chart.