摘要
【目的】分析右室流出道(RVOT)起源室性早搏的心电图特征及其与消融靶点的关系,探讨RVOT室性早搏有效准确的心电图定位方法。【方法】回顾分析2001-2008年在我院行射频消融的RVOT室性早搏62例,依据成功消融靶点X线定位结果,分析其与心电图各项指标的关系。【结果】在RVOT早搏中,游离壁与间隔部起源相比Ⅱ,Ⅲ,AVF导联R波宽伴有切迹(P<0.05)。Ⅰ导联呈QS或rsr’提示室早源自RVOT前部,呈R或rR则起源于后部,(P<0.05)。Ⅱ,Ⅲ,AVF导联R波越高(P<0.05),胸前导联R/S移行越早(P<0.05)提示早搏距离肺动脉瓣越近。【结论】在RVOT起源的室早中Ⅱ,Ⅲ,AVF导联R波宽度判断早搏源于间隔或游离壁,Ⅰ导联QRS波形态判断早搏源于RVOT前部或后部,Ⅱ,Ⅲ,AVF导联R波高度结合胸前导联R/S移行判断早搏接近肺动脉瓣或三尖瓣。
[Objective] To analyze the relationship between ECG and target ablation site of ventricular premature contraction （VPC） originated from right ventricular outflow tract （RVOT） and to investigate the effective method to localize the VPC origination. [Methods] 62 patients（pts） hospitalized for radiofrequency ablation within 2001 to 2008 with VPC from RVOT were retrospectively analyzed, Correlative relation between successful ablation site based on X ray films and a variety of ECG parameters were studied. [ ResultS]In VPC from RVOT, wide and notched R wave of Ⅱ, Ⅲ, AVF indicated VPC originating from free wall （P 〈0.05）, QS or rsr＇ type in lead I suggested VPC originating from anterior wall, R or rR type indicated posterior wall origination （P 〈0.05）. high R wave in Ⅱ,Ⅲ, AVF （P〈0.05）with early R/S transition（ P 〈 0.05） revealed VPC adjacent to pulmonary valve. [Conclusions] In VPC from RVOT the width of R wave in lead Ⅱ , Ⅲ, AVF was sensitive to localize VPC from free wall or septal. QRS configuration in lead Ⅰ was of use to distinguish VPC from anterior or posterior part within HVOT. The amplitude of R wave in lead Ⅱ , Ⅲ, AVF combined with R/S transition in precordial lead could predict VPC adjacent to pulmonary valve or tricuspid valve.
出处
《武警医学院学报》
CAS
2010年第1期29-31,F0003,共4页
Acta Academiae Medicinae CPAPF
关键词
室性早搏
右室流出道
心电图
射频消融
Ventricular premature contraction
Right ventricular outflow tract
ECG
Radiofrequency ablation
