特发性左室流出道室性心律失常的心电图特点

探讨特发性左室流出道室性心律失常患者的心电图特点。对 7例特发性左室流出道室性早搏 (简称室早 )、室性心动过速 (简称室速 )患者进行心电图分析 ,并行心内电生理检查及射频消融治疗 ,同时对 10例预激综合征患者成功消融房室旁道后行主动脉瓣上及瓣下起搏 ,记录同步 12导联起搏心电图。对比分析两组病例体表心电图QRS波图形特点。结果 :7例左室流出道室早、室速患者经心内电生理检查证实 6例起源于冠状动脉窦内 ,1例起源于左室流出道主动脉瓣右瓣下方 ,所有患者经射频消融成功治疗室性心律失常。对照组 10例在主动脉瓣下起搏(其中 6例同时在主动脉瓣上起搏 )获得同步 12导联起搏心电图。两组病例体表心电图共同特点为 :QRS波额面电轴向下 ,Ⅱ、Ⅲ、aVF导联主波向上 ,QRS波在V2 或V3 前移行为Rs或R型。结论 :左室流出道为特发性室早、室速发生部位之一 ,体表心电图有其独特性 ,导管射频消融治疗安全有效。

Electrocardiographic Characteristics of Left Outflow Tract Ventricular Arrhythmia

To evaluate the electrocardiographic characteristics of left outflow tract ventricular arrhythmia and the effect of radiofrequency catheter ablation,7 patients with ventricular arrhythmia and 10 patients with WPW were involved in the study. Ventricular arrhythmia were proved to originating from left outflow tract by electrophysiologic study and abolished successfully by radiofrequency catheter ablation. Meanwhile 10 patients with WPW were paced in left outflow ventricular tract after ablation of accessory pathway. Results:The ventricular arrhythmias originated from Valsalva sinus in 6 patients and subaortic valve in one. All 7 patients were successfully ablated. The electrocardiographic pattern of QRS complexes both during pacing at left ventricular outflow tract and tachycardia arrhythmias showed inferior axis, a positive QRS complex in lead Ⅱ, Ⅲ, aVF and early precordial transition with Rs or R in V 2 or V 3. Conclusions:Idiopathic ventricular tachycardia originated from left outflow tract could be known by a specific characteristic of surface electrocardiography and cold be radically treated safely by catheter ablation.