散点漂移法快速识别二度房室阻滞合并频发性早搏

Application of scatter point drifting method in rapid identification of second degree atrioventricular block complicating frequent premature beats

选择二度房室阻滞合并频发室性早搏及交界性早搏的心律失常病例,分析其心电散点图特征,总结分析技巧。房室阻滞所致长周期相关的特征点集与无长周期的同名特征点集有相似性,相当于由后者漂移而来。Lorenz散点图的漂移规律为前周期延长向右移,后周期延长向上移,前后周期均延长向右上移;差值散点图的漂移规律为前周期延长向左移,后周期延长向上移,中间周期延长向右下移。房室阻滞所致长周期的出现,使原有的心律失常散点图复杂化,而散点漂移法正是识别此类病例的“秘密武器”。

We selected patients with second degree atrioventricular block(AVB)complicating frequent premature ventricular beats and junctional premature beats.Their characteristics of ECG scatter plot were analyzed,and analysis skills were summarized.There is an analogy between the characteristic point set related to second degree AVB-induced long period and the homonymous one without long period.The former is equivalent to a drift from the latter.The drifting law of Lorenz scatter plot is as follows:the front period is extended and moves to the right,the back period is extended and moves up,and both of the front and back period extend to the upper right.The drifting law of difference scatter plot is as follows:the front period is extended and moves to the left,the back period is extended and moves up,and the middle period is extended and moves to the bottom right.The appearance of AVBinduced long period complicates the original scatter plot of arrhythmia.The scatter point drifting method serves as a“secret weapon”to identify these cases.