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患者霍××,女性,79岁。临床诊断:支气管炎、肺气肿。附图为连续记录的V_1导联及其梯形图解:P波直立,P—R间期0.14秒,P—P间期0.48秒均齐,心率125次/分,显示窦性心动过速。QRS波除正常窦性下传的外,还有两种形态提早发生的QRS波,其时间均为0.08秒。R_2、P_4前无相关的P波,提早发生的QRS波与前一窦性心搏的配对间期不一致(分别为0.48秒、0.42秒、0.50秒、0.34秒)。图中异位搏动长的R—R间期与短的R—R间期最大公约数为0.64秒,属于典型的交界性并行收缩。但可见R_1R_3前有相关的P波,P—R间期为0.14秒,QRS波形态与窦性和交界性搏动不同。T波与主波方向相反,配对间期较R_2和R_4为长。为交界区激动与下传的窦性激动在交界区传导的路径不一,而分别激动心室肌的不同部位。由于两个激动几乎是同时到达心室,并在心室发生融合继而产生了第三种QRS波即室性融合波。本例心电图诊断:1.窦性心动过速;2.交界性并行收缩;3.室性融合波。
Huo × × patients, women, 79 years old. Clinical diagnosis: bronchitis, emphysema. The figure for the continuous recorded V_1 lead and its ladder diagram: P wave upright, P-R interval 0.14 seconds, P-P interval 0.48 seconds are homogeneous, heart rate 125 beats / min, shows sinus tachycardia. QRS wave in addition to the normal sinus beats, there are two forms of QRS waves occurred early, the time is 0.08 seconds. There was no correlation of P-wave before R_2 and P_4, and the premature QRS wave was inconsistent with that of the previous sinus rhythm (0.48s, 0.42s, 0.50s and 0.34s, respectively). The figure of the ectopic beats long R-R interval and the shortest R-R interval of the greatest common divisor of 0.64 seconds, belonging to the typical borderline parallel contraction. However, it can be seen that there is correlation P wave before R_1R_3, the P-R interval is 0.14s, and the morphology of QRS wave is different from that of sinus and borderline. The T wave is opposite to the main wave direction, and the matching period is longer than that of R_2 and R_4. The junctional zone excitement and the next transmission of sinus excitement in the junction of the conduction path is different, and respectively, different parts of the ventricular myocardium. As the two excited almost simultaneously reached the ventricle, and in the ventricular fusion followed by the generation of a third QRS wave that is the fusion chamber wave. In this case ECG diagnosis: 1. sinus tachycardia; 2. borderline parallel contraction; 3. ventricular fusion wave.