摘要
目的探讨心电图在预激综合征并发心房颤动时的特征及诊治。方法选择我院预激综合征并发心房颤动的患者20例,对其心电图特点及表现进行回顾性分析。结果本组20例患者,合并器质性心脏病患者7例,均给予针对性的综合治疗,其窦性心律分别在应用乙胺碘呋酮、普罗帕酮及电复治疗后转复。对13例无器质性病变的患者,分别应用乙胺碘呋酮或普罗帕酮转复为窦性心律。QRS波在房颤时,经旁路前传呈一致宽大畸形,与窦性心律在形态上完全相似,诊断为预激综合征并发房室传导阻滞(完全性)的患者,可采用永久性起搏器直接植入。大致可根据体表心电图确定有左右两条旁路,经两条旁路快速房颤交替下传,提示传导阻滞在房室正道中存在。结论临床上对宽QRS波群又呈心动过速表现时,应想到预激综合征并发房颤的发生,做好充分的鉴别诊断后再应用抗心律失常药物。对患者的生命体征做好密切监测,为电复律做好准备,对条件具备的患者,治疗时可应用导管射频消融根治。
Objective To investigate the electrocardiogram of atrial fibrillation in WPW syndrome and treatment characteristics of the time.Methods Pre-excitation syndrome in our hospital 20 patients with atrial fibrillation,ECG characteristics and performance of their retrospective analysis.Results 20 patients,7 patients with structural heart disease combined,were given specific comprehensive treatment,the sinus rhythm,respectively,in the application of amiodarone,propafenone,and electrical cardioversion cardioversion after treatment.13 cases of patients with no organic disease,were applied amiodarone or propafenone cardioversion to sinus rhythm.QRS wave in the atrial fibrillation was unanimously passed by the bypass before the large deformity in the form of sinus rhythm is completely similar to the diagnosis of pre-excitation syndrome atrioventricular block（complete） patients,permanent pacing can be for direct implantation.Roughly around under the surface ECG identified two bypass,bypass atrial fibrillation by alternating two downstream,suggesting that AV conduction block in the right way there.Conclusion The clinical group of wide QRS wave and the performance was tachycardia,WPW syndrome should be thought of the occurrence of atrial fibrillation,and then make the full application of the differential diagnosis of anti-arrhythmia drugs.Do a good job of patient vital signs are closely monitored to prepare for the electrical cardioversion,in patients with the condition,treatment can be applied to radiofrequency catheter ablation to cure.
出处
《黑龙江医学》
2011年第3期205-207,共3页
Heilongjiang Medical Journal
关键词
预激综合征
并发
心房颤动
心电图
临床分析
Pre-excitation syndrome
Concurrent
Fibrillation
Electrocardiogram
Clinical analysis
