流出道起源的室性心律失常体表心电图特点分析
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陕西省重点研发计划项目(2024SF-YBXM-192);


Surface electrocardiogram features of outflow tract ventricular arrhythmias
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    摘要:

    目的:分析室性心律失常患者不同流出道起源的体表心电图特点。方法:纳入室性心律失常患者102例,所有患者均进行标准12导联心电图检查,记录不同心室流出道起源患者及右室流出道不同肺动脉瓣起源位置患者的心电图特征及参数。结果:102例患者体表心电图均表现为下壁导联R波正向,在aVL和aVR均表现为QS型。102例患者中左室流出道19例,右室流出道83例;其中肺动脉瓣上起源44例,肺动脉瓣下起源39例。右室流出道组R波振幅、最小RS时间(SRS)、类本位曲折时间(IDT)均低于左室流出道组(P<0.05)。右室流出道不同肺动脉瓣起源位置患者比较,肺动脉瓣上组Ⅱ导联及aVF导联R波振幅均高于肺动脉瓣下组,RⅢ/RⅡ低于肺动脉瓣下组(P<0.05)。右室流出道肺动脉瓣上起源不同解剖位置患者的QRS时限、Ⅲ导联及aVF导联R波振幅、aVL导联Q波振幅、RⅢ/RⅡ比较,差异均有统计学意义(P<0.05);右窦组QRS时限高于左窦组,Ⅲ导联R波振幅、aVF导联R波振幅、aVL导联Q波振幅、RⅢ/RⅡ低于左窦组与前窦组,aVL导联Q波振幅低于左右窦交界组(P<0.05);左窦组Ⅲ导联R波振幅、aVF导联R波振幅高于左右窦交界组(P<0.05)。结论:流出道起源存在差异的室性心律失常患者具有不同的体表心电图表现且参数存在显著差异,临床可通过体表心电图参数对室性心律失常患者的流出道起源位置进行分析与判定。

    Abstract:

    Objective:To analyze surface electrocardiogram features of patients with ventricular arrhythmias arising from different outflow tracts.Methods:102 patients with ventricular arrhythmias were enrolled in this study.All of them underwent standard 12-lead electrocardiography.Electrocardiogram features and parameters of patients with ventricular arrhythmias arising from different ventricular outflow tracts and different positions of pulmonary valve in the right ventricular outflow tract were recorded.Results:All patients in-cluded in this study showed positive R waves in inferior wall leads on surface electrocardiograms,and QS pattern in aVL and aVR.A-mong the 102 patients,there were 19 cases with left ventricular outflow tract arrhythmias and 83 cases with right ventricular outflow tract arrhythmias,including ventricular arrhythmias arising above pulmonary valve(n=44)and below pulmonary valve(n=39).R wave amplitude,shortest RS(SRS),and intrinsicoid deflection time(IDT)in the right ventricular outflow tract group were smaller and shor-ter than those in the left ventricular outflow tract group(P<0.05).For patients with ventricular arrhythmias arising from different posi-tions of pulmonary valve in the right ventricular outflow tract group,R wave amplitude in lead II and lead aVF in the above pulmonary valve group was greater than that in the below pulmonary valve group,while RⅢ/RⅡwas lower than that in the below pulmonary valve group(P<0.05).There were statistically significant differences in QRS duration,R wave amplitude in lead III and aVF,Q wave am-plitude in lead aVL,and RⅢ/RⅡ among patients with ventricular arrhythmias originating from different anatomical parts of pulmonary valve(P<0.05).QRS duration in the right sinus group was longer than that in the left sinus group.The R wave amplitude in lead Ⅲ and aVF,Q wave amplitude in lead aVL and RⅢ/RⅡwere smaller than those in the left sinus group and the anterior sinus group.The Q wave amplitude in lead aVL was smaller than that in the left and right sinus junction group(P<0.05).R wave amplitude in lead Ⅲ and aVF in the left sinus group was greater than that in the left sinus junction group(P<0.05).Conclusion:Patients with ventricular arrhythmias arising from different outflow tracts have different surface electrocardiogram features and parameters.Clinically,the outflow tract where ventricular arrhythmias originate can be determined by relevant surface electrocardiogram parameters.

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白红艳;李刘文;黄莉;.流出道起源的室性心律失常体表心电图特点分析[J].川北医学院学报,2025,40(6):723-726.

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  • 在线发布日期: 2025-07-09
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