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QRS波时限是心室除极的时间,其正常值为0.07~0.10S。QRS波时限延长表明心肌电不稳性增加,促发折返性室性心律失常发生。室性早搏的QRS波时限增宽,常伴有心功能不全、心室腔扩大、冠状动脉多支血管病变及短阵室性心动过速发生率高。在诊断冠心病方面,QRS波时限延长是心肌梗死或冠心病死亡的独立预测因子。运动试验中QRS波时限延长提示心肌缺血,冠状动脉造影确诊冠心病的敏感性和特异性分别达82%和88%。慢性心衰患者随着病情的进展,心肌收缩功能减退,心肌收缩不同步,在心电图上表现为QRS波时限增宽,易导致猝死和恶性心律失常。病态窦房结综合征患者安装起搏器,右室流出道起搏与右室心尖部起搏比较,QRS波时限短,射血分数有所改善。法络氏四联症修复术后,QRS波时限≥180 ms,预测可诱发室性心动过速。总之,体表心电图QRS波时限为我们提供了心脏结构、功能、预后等信息,为我们全面评估患者病情提供了依据。
QRS wave time is the time of ventricular depolarization, its normal value of 0.07 ~ 0.10S. The prolongation of the QRS wave duration indicates increased electrical instability of the myocardium, triggering reentrant ventricular arrhythmias. Premature ventricular contractions of the QRS wave widening, often accompanied by cardiac insufficiency, ventricular enlargement, coronary artery disease and paroxysmal ventricular tachycardia incidence. In the diagnosis of coronary heart disease, prolonged QRS wave duration is an independent predictor of myocardial infarction or coronary heart disease death. The prolongation of QRS wave duration in exercise test suggests that the sensitivity and specificity of coronary angiography in diagnosing coronary artery disease are up to 82% and 88% respectively. Patients with chronic heart failure as the disease progresses, myocardial systolic dysfunction, myocardial contractions are not synchronized in the ECG showed QRS wave widening of the time limit, can easily lead to sudden death and malignant arrhythmia. Sick sinus syndrome patients with pacemaker, right ventricular outflow tract pacing and right ventricular apical pacing comparison, QRS wave duration is short, ejection fraction improved. After the treatment of tetralogy of Fallot, QRS wave duration ≥ 180 ms, predictive can induce ventricular tachycardia. In short, surface ECG QRS wave time limit provides us with heart structure, function, prognosis and other information for our comprehensive assessment of the patient’s condition provides a basis.