摘要
总结射频消融成功的后间隔旁道３７例体表及心内电图特征，结果显示：显性后间隔旁道体表心电图Ⅱ、Ⅲ、ａＶＦ导联δ波负向，ＱＲＳ波群在Ｖ２导联呈Ｒ或Ｒｓ形时，若Ｖ１导联为ｒＳＲ或Ｒｓ形诊断为左后间隔旁道，其敏感性７３．３％、特异性９１．７％；Ｖ１导联为ＱＳ形诊断为右后间隔旁道，其敏感性５８．３％、特异性１００％。冠状窦电极为间距１ｃｍ的４极标测电极，近端电极置于窦口。心动过速时，心内电图ΔＶＡＨ－ＣＳ（ＶＡＨ与最短ＶＡｃｓ的差值）≥２５ｍｓ提示左侧，敏感性６２．８％、特异性９３．７％；ΔＶＡｃｓ（冠状窦电极记录的最长与最短ＶＡ的差值）≤１５ｍｓ提示左侧，敏感性８７．５％，特异性９５．４％。此外，左后间隔旁道逆行Ａ波最早出现在冠状窦近端（ＣＳｐ）或冠状窦中端（ＣＳｍ），且冠状窦中端Ａ波（Ａｃｓｍ）均早于希氏束远端（Ｈｉｓｄ）Ａ波（ＡＨｉｓｄ）；右后间隔旁道逆行Ａ波最早出现在Ｈｉｓｄ或ＣＳｐ处，Ａｃｓｍ均晚于ＡＨｉｓｄ。通过体表心电图和心内电图特征，可简便准确地预测间隔旁道的消融靶点。
The Electrocardiogram (ECG) characteristics and electrophysiological parameters were analyzed in 37 patients with posteroseptal accessory pathway (AP) underwent successful radiofrequency catheter ablation.If negative delta wave was found in lead Ⅱ、Ⅲ、aVF,R or Rs in lead V 2,rSR or Rs in lead V 1,it suggested left posteroseptal AP (sensitivity 73.3%,specificity 91.7%).QS pattern in lead V 1 suggested right posteroseptal AP (sensitivity 58.3%,specificity 100%).Coronary sinus catheter was a 6 F four polar electrode catheter with 1 cm interval.The most proximal electrode stradding the ostium.During tachycardia,△VA H CS ≥25 ms,VAcs≤15 ms suggested a left side posteroseptal AP.Otherwise,that suggested a right side posteroseptal AP.The retrograde A wave in left posteroseptal AP was earler in CSp or CSm and Acs m was always earlier than A His d .A wave was earler in His d or CSp and the Acs m was always later than A His d in right posteroseptal AP.By the surface ECG and electrophysiological parameters,we can accurately locate left or right posteroseptal AP.
出处
《中国心脏起搏与心电生理杂志》
1997年第2期79-81,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
后间隔
房室旁道
心电图
电生理学
Posteroseptal Atrioventricular accessory pathway Electrocardiogram Electrophysiology
