起源于上腔静脉的房性心律失常体表心电图心房波特征

分析起源于上腔静脉的房性心律失常的体表心电图心房波变化特征,以了解心房波形态对判断房性心律失常起源部位的价值。测量8例上腔静脉起源的房性心律失常患者窦性心律(简称窦律)及阵发性房性心律失常时心电图12导联的心房波时限、振幅及极性,并比较二种节律各导联房波的变化特点。结果:房性心律失常时各导联异位心房波的时限与窦律时相比无明显变化;其Ⅱ、Ⅲ、aVF导联心房波振幅明显高于窦律时;I导联P波由窦律时的明显正向变为低平,基本处于等电位线,aVL导联的P波由窦律下的低平变为负向,振幅仍很低;胸前导联心房波无明显变化。房性心律失常时Ⅱ导联心房激动振幅高于Ⅲ、aVF。结论:上腔静脉起源的房性心律失常其典型心电图特征为,Ⅱ、Ⅲ、aVF导联心房波直立高大,在I导联为正向低平波,aVL导联为负向低幅波。

Characteristic of Atrial Wave in Electrocardiogram of Atrial Arrhythmias Originating From Superior Vena Cava

To analyze characteristic of atrial wave of atrial arrhythmias originating from superior vena cava for evaluting the morphology of atrial wave to atrial arrhythmias initiating sites, the duration, amplitude and polarity of atrial wave of 12 leads was measured both in sinus rhythm and in paroxysmal atrial arrhythmias of eight patients suffering from atrial arrhythmias originating from superior vena cava. Characteristic of atrial wave in two rhythms was compared. Results: There was no significant difference in duration of atrial wave between atrial arrhythmias and sinus rhythm. Amplitude of atrial wave in Ⅱ, Ⅲ and aVF during tachyarrythmias increased markedly compared to sinus rhythm; Atrial wave in lead I changed from distinctly erect waves to lower ones near to isoelectric line, and that in lead aVL changed from low-level waves in sinus rhythm to reverse and low-amplitude ones; Atrial wave in precordial leads had not any change. During atrial arrhythmias, amplitude of atrial wave in lead Ⅱ was higher than in lead Ⅲ or aVF. Conclusion: The typical characteristic of electrocardiogram in the patients with atrial arrhythmias originating from superior vena cava is erect and high-amplitude atrial wave in Ⅱ, Ⅲ and aVF, erect but low in lead I and reverse and low in lead aVL during arrhythmias occurrence.