论文部分内容阅读
患者女性,59岁,临床诊断冠心病。附图(aVF 为连续记录)可见缓慢的交界区逸搏心律,QRS 波前无 P 波,其后可见逆行 P~-波,R-P′为0.28s,恒定不变,因伴有完全性右束支传导阻滞,故 QRS 时限达0.12s。逸搏伴1∶1逆向性传导,P~-深倒达0.4mV,似肺型 P 波的镜像倒影。交界性逸搏在逆传心房同时,有部分在逆行传导过程中又沿另一条房室径路折返至心室,形成交界性反复心搏,如 aVF 导联 R_(2,6)和 R_8及Ⅱ导联 R_(3,5)均为折返的 QRS 波,R-R′为0.50s;aVF R_6及 V_6 R_2前可见直立 P 波,P-R>0.12s,属心室夺获。窦性 P 波形态正常,患者又无右房肥大的依据,深倒 P~-符合逆向性右房内差异传导的心电图表现。本例心电图诊断:(1)窦性静止,偶见窦性搏动,(2)交界区逸搏心律伴反复心律及逆向性右房内差异传导,(3)不完全性房室分离,可见心室夺获,(4)完全性右束支
Female patient, 59 years old, clinically diagnosed with coronary heart disease. The figure (aVF for continuous recording) shows a slow junction zone escape rhythm, QRS wavefront without P wave, followed by visible retrograde P ~ - wave, RP ’is 0.28s, constant, due to complete right bundle Branch conduction block, so the QRS limit of 0.12s. Yat stroke with 1: 1 reverse conduction, P ~ - down 0.4mV, like lung P wave reflection. Jardine Atrioventricular retrograde atrial at the same time, some in the retrograde conduction process and along another atrioventricular route returned to the ventricle, the formation of borderline repeated heartbeat, such as aVF lead R_ (2,6) and R_8 and Ⅱ guide The R_ (3,5) were all reentry QRS wave, RR ’is 0.50s; aVF R_6 and V_6 R_2 before the visible vertical P wave, PR> 0.12s, is a ventricular seizure. Sinus P wave morphology is normal, the patient has no basis for right atrial hypertrophy, deep down P ~ - consistent with reverse right ventricular differential conduction ECG performance. This case of ECG diagnosis: (1) sinus quiescence, occasional sinus beats, (2) border zone escaping rhythm and repeated rhythm and reverse right ventricular differential conduction, (3 incomplete partial atrioventricular septal ventricular can be seen Captured, (4) Completely right bundle branch