镜像右位心合并左前半分支传导阻滞1例

患者男性,4岁。因入托前健康体检而来我院。体检:HR 105次/分.未闻及病理性杂音。常规心电图示:P波时限O.08 s,P-R间期0.12 s,QRS时限0.09 s,Q-r间期0.32 s,R-R间距不等。相差>O.12 s.HR平均心率110次/分。1、aVF导联的P-QRS-T波群向下.aVF导联的P～QRS-T波群直立,Ⅱ、Ⅲ、aVF导联呈rs型,电轴左偏达-41度。V3～V5导联QRS波     

200只比格犬心电图分析

目的　对不同年龄的比格 (Beagle)犬 ,进行了6个导联的心电图描记和分析 ,建立了心电图基本数据。方法　 2 0 0条 6～ 36月龄Beagle犬 ,在清醒情况下记录Ⅰ、Ⅱ、Ⅲ、aVR、aVL和aAF 6个导联的心电图。结果　 2 0 0只Beagle犬均为窦性心律。不同性别和年龄的犬心率不同 ,雌性犬略快 ,随年龄增加 ,心率变缓。Beagle犬心电图各波形与人相似 ,P R间期为 0 .0 9～ 0 .12s ,QRS波群为 0 .0 4～ 0 .0 6s ,Q T间期为 0 .17～ 0 .2 1s。随着年龄增大 ,P R间期和Q T间期延长 ,QRS波群年龄性别差异不显著。S T段一般与QRS末端合并 ,大多数位于等电位线 ,S T段上移的占 12 % ,一般为上抬或斜升型下降 ,但一般不超过 1mm。Beagle犬存在着窦性心律不齐 ,比例为 15 %。结论　建立了心电图基本数据 ,可供实验时参考     

心得安试验加重ST—T改变l例

患者女性，50岁。2001－07—11因子宫肌瘤人院。平素无心慌、胸闷及其他病史。检查：血压150／100mmHg(20／13．3kPa)。常规心电图示：Ⅱ、Ⅲ、aVF导联ST段略压低，V4—V6导联T波呈负正双向(图1)。即给予心得安20mg口服后90min做心电图鉴别试验。结果，心率由试验前的90次／min，降为68次／min，T波I、aVL导联由直立变为倒置，aVR导联T波变直立，原来压低的ST段Ⅱ、Ⅲ、aVF较前明显降低．且T流Ⅱ、Ⅲ、aVF由直立变为负正双向，TV4-V6由负正双向变为倒置(图2)。3d后重复上述试验检查，结果与首次试验相同。     

心电图QRS综合波改变对早期诊断急性下壁心肌梗死的意义

目的通过胸痛患者连续心电图监测,以便早期确诊急性下壁心肌梗死。方法在30例患者中,根据胸痛开始5h内连续描记常规12个导联心电图,测定各导联R波、S波振幅及ST段变化,与心肌梗死前正常心电图作比较。结果所记录的心电图改变中,Ⅱ、Ⅲ、aVF导联QRS波群的S波消失,出现高尖R波,下壁心肌梗死aVL导联S波的改变也有重要诊断意义。结论急性下壁心肌梗死早期心电图最显著的改变,表现在Ⅲ、aVF、aVL导联QRS综合波终末电压的增高。     

不完全性心房内传导阻滞2例报告

本文报道2例不完全性心房内传导阻滞,并对其机理进行初步分析。例1,男性,52岁,肺心病患者,心电图见图1。入院当天心电图呈窦性心律,P-R间期,R-R间期固定,ST段下垂型压低,T波倒置。Ⅲ导联P波时限0.08秒,振幅0.10mv,P-R间期0.12秒,aVF导联见双峰P波,P波时限0.12秒,峰间距0.06秒。入院后29天描记心电图,见Ⅲ导联P波时限0.08秒,振幅增至0.35mv,aVF导联双峰P波消失,出现P波高尖,     

完全性房室传导阻滞房室交接处逸搏心律伴3:2传出文氏现象1例

患者,男,24岁。主诉三四年来夜间不能自主活动且叫不出声音,猛用力才能缓解。听诊心尖部有Ⅲ级收缩期杂音并可闻及第三心音,肺部(-),心功能及超声心动图未见异常,BP16/9.5kPa。门诊心电图可见P波在Ⅰ、Ⅱ导联直立,aVR倒置系窦性P波,P-P间期为0.85～0.93秒,心室率缓慢,R-R间期长短交替,长间歇约为1.42秒,短间歇约为1.14秒,QRS波群形态一致,P波与QRS波群无固定关系,且在P波距R波较远时未发现逆行P波,故诊断为:1.窦性心率;2.完全性房室传导阻滞;3.房室交接处逸搏心律伴3:2传出文氏现象。做出此诊断必须与完全性干扰性房室脱     

怀孕与未孕乳牛心电图的比较

本论文试验的主要目的是探讨怀孕与未怀孕乳牛心电图的差异。 选黑白花乳牛20头,其中未孕牛5头(对照用)孕牛15头,分别对它们作了三个标准肢导联和三个加压单极肢导联共六个导联心电图的波形、振幅及时限的测定。 所得结果:1.在 Ⅰ、Ⅱ、Ⅲ和aVF四个导联中,孕牛与未孕牛的P波均为正波,而aVR导联全为负波;2.在Ⅰ导联中QS波出现率,孕牛为未孕牛的3.2倍;因此,孕牛的心电轴右偏比未孕牛也多;3.Ⅱ导联的T波,孕牛多为负波,出现率为78％;而未孕牛全为正波;4.在各导联中,孕牛的P波、T波、QRS复合波的时限,多比未孕牛者短,孕牛的P—R间期、Q—T间期、S—T段也比未孕牛的短;5.孕牛的平均心率为90.8次/分,未孕牛为86.3次/分。孕牛心率比未孕牛略高。     

心力衰竭治疗前后aVR导联QRS波振幅与脑钠肽的变化

目的探讨心力衰竭患者利尿治疗前后aVR导联QRS波振幅与脑钠肽变化的关系,探讨心力衰竭治疗有效的心电图指标,为临床疗效评估提供简便易行的预测方法。方法观察心力衰竭患者50例,分别于入院时利尿治疗前及治疗后出院时行12导联心电图检查,观察aVR导联QRS波振幅变化;监测体重;测定脑钠肽浓度。结果心力衰竭患者经利尿治疗后心电图aVR导联QRS波的振幅较治疗前显著增高,体重显著下降,BNP显著下降。结论aVR导联QRS波振幅变化与脑钠肽可以用来评估心力衰竭患者利尿治疗疗效的简单可靠的指标。     

怀孕与未孕乳牛在九种导联心电图的比较

用XQ—IA型心电图机(中国上海七一器材厂出品)对52头黑白花乳牛(内39头已孕,13头未孕)进行了心电图测定。测定心电图所用的导联共9个,即分别为:三个标准导联,三个加压肢导联和三个单极心前导联。所得结果如次:1.孕牛与未孕牛的心电轴均有左、右偏移现象;2.孕牛心率则未孕牛稍高,但不显著;3.在标准Ⅱ导联、aVR、aVF三个导联中,孕牛的P波电压比未孕牛者增加,而且在Ⅱ导联和aVR导联中非常明显(P<0.01);4.aVR、aVF的P波时间,孕牛比未孕牛有较明显的延长(0.01相似文献   

心肌缺血引起QRS-T波呈1:1电交替1例

患者 ,男 ,29岁 ,因阵发性心悸、胸闷两天 ,并出现全身乏力和食欲减退就诊。随查心电图 :窦性心律 ,T波I、浕ｖＬ倒置 ,Ⅱ、Ⅲ、avf直立 ,V1～V3呈双向 ,T波V4～V6直立。U波V4～V6倒置。随着连续记录Ⅱ导联 (图1)可见两种形态不同的QRS -T波群呈1 :1交替出现 ,R -R间期为88次/分 ,P -R间期为0 20秒。两种QRS波形间期固定 ,P波形态一致 ,当R波高时T波低平 ,R波低时T波直立 ,心电图诊断为轻度心肌缺血。图1两种形态不同的QRS -T波群呈1 :1交替出现心肌缺血时 ,多表现为ST-T的改变。而U波倒置也常见于心肌缺血、高血压、冠心病以…     

射频消融治疗起源于左室流出道的室性心动过速和频发室性期前收缩

目的 探讨源自左室流出道部位的室性心动过速(室速)和室性期前收缩(室早)的心电图特点和射频消融的安全性.方法 对9例于左室流出道部位消融的室速/室早病例的心电图和射频消融情况进行归纳总结.结果 消融成功部位6例在左冠窦内,3例在主动脉瓣下.心电图特点:(1)Ⅱ、Ⅲ、avF导联均呈高R波;(2)aVR和aVL导联均呈QS型,且aVL振幅多大于aVR;(3)Ⅰ导联多呈QS型;(4)V1导联R波偏高:R/S>0.62;(5)胸前导联R波移行不规则;(6)V5、V6多呈R型.9例均消融成功,无复发病例,无左主干及主动脉瓣损伤.结论 源自左室流出道的室速/室早具有独特的心电图表现,射频消融能安全有效地根治此类心律失常.     

心电指标改变和心血池造影定量分析在肺心病中的临床应用

目的探讨在平衡法心血池造影和心电检测各指标的改变,以评价肺心病患者的心功能。方法对38例肺心病失代偿期(包括急性加重期)患者和18例肺心病代偿期(包括缓解期)患者进行平衡法心血池造影和心电检测。结果肺心病患者随着病情的加重,STⅡ,Ⅲ,aVF压低可出现肺型P波、紊乱性房性心动过速、极度顺钟向转位;高峰充盈率和射血分数均逐渐下降,高峰充盈时间改变不明显。结论心室的泵功能与肺心病本身病情的轻重有密切的关系,应用心电检测各指标结合核素平衡法心血池造影,可用于早期诊断肺心病和评价肺心病患者的心功能。     

巴马小型猪植入式遥测动物模型的建立及应用

目的 基于遥测技术建立适用于监测清醒自由活动状态下巴马小型猪心电、血压、体温等生理指标的动物模型,为其在安全药理学研究中的应用提供支持。方法 8只巴马小型猪（雌雄各半）经手术植入植入子,手术后恢复3~4周,经体格检查确认已完全恢复后,采用EMKA遥测系统连续监测至少24 h心电图、血压等生理指标,包括心率、PR间期、QRS间期、QT间期、校正QT （QTcv）间期、体温、收缩压（SBP）、舒张压（DBP）、平均动脉压（MBP）,并于次周重复监测1次。对巴马小型猪的24 h指标变化进行分析,并与Beagle犬和食蟹猴数据进行种属间比对分析。结果 巴马小型猪的心电数据和血压数据昼夜节律均不明显;体温呈现明显的昼夜节律,白天体温高,夜间体温低;动物的心率、血压和体温均受外界影响比较大,与动物的活动呈现明显的相关性;与Beagle犬和食蟹猴比较,巴马小型猪的心率和人类最为相似,SBP仅稍高于人类。结论 通过体内植入植入子,成功建立了巴马小型猪植入式遥测动物模型;与Beagle犬和食蟹猴比较,巴马小型猪更适合用于药物对心血管系统影响的评价。     

QT PRODACT: in vivo QT assay with a conscious monkey for assessment of the potential for drug-induced QT interval prolongation

In safety pharmacology studies, the effects on the QT interval of electrocardiograms are routinely assessed using a telemetry system in cynomolgus monkeys. However, there is a lack of integrated databases concerning in vivo QT assays in conscious monkeys. As part of QT Interval Prolongation: Project for Database Construction (QT PRODACT), the present study examined 10 positive compounds with the potential to prolong the QT interval and 6 negative compounds considered to have no such effect on humans. The experiments were conducted at 7 facilities in accordance with a standard protocol established by QT PRODACT. The vehicle or 3 doses of each test compound were administered orally to male cynomolgus monkeys (n=3-4), and telemetry signals were recorded for 24 h. None of the negative compounds prolonged the corrected QT using Bazett's formula (QTcB) interval. On the other hand, almost all of the positive compounds prolonged the QTcB interval, but haloperidol, terfenadine, and thioridazine did not. The failure to detect the QTcB interval prolongation appeared to be attributable for the differences in metabolism between species and/or disagreement with Bazett's formula for tachycardia. In the cynomolgus monkeys, astemizole induced Torsade de Pointes and cisapride caused tachyarrhythmia at lower plasma concentrations than those observed in humans and dogs. These results suggest that in vivo QT assays in conscious monkeys represent a useful model for assessing the risks of drug-induced QT interval prolongation.     

Effects of terfenadine, astemizole and epinastine on electrocardiogram in conscious cynomolgus monkeys.

We examined the effects of non-sedative histamine H1 receptor antagonists on the electrocardiogram (ECG) in conscious cynomolgus monkeys. Terfenadine (3 mg kg(-1) h(-1), i.v.) and astemizole (0.3 and 1 mg kg(-1) h(-1), i.v.) caused significant time-dependent increases in the QT interval and QTc Bazett (QTc). However, normal ECG forms were found during a 60-min infusion of epinastine (3 mg kg(-1) h(-1) i.v.). A higher dose of epinastine (10 mg kg(-1) h(-1), i.v.) increased the QTc and PR interval only 5 min after the start of the infusion. The minimum plasma concentrations of terfenadine, astemizole and epinastine which caused QTc prolongation were 85, 35 and over than 3600 ng/ml, respectively. These drugs did not alter the PQ and QRS intervals and did not cause arrhythmia or atrioventricular block. Our results are consistent with the clinical observation that prolongation of QTc is caused by terfenadine and astemizole but not by epinastine. Thus, measurement of QTc in cynomolgus monkey appears to be a useful approach for evaluating the potential cardiotoxicity of histamine H1 receptor antagonists.     

Evaluation of QT interval using a linear model in individual cynomolgus monkeys

INTRODUCTION: The cynomolgus monkey, one of a number of primate species phylogenetically close to humans, is commonly used in cardiovascular research, but a method for determination of the RR interval-corrected QT interval in this species needs greater consideration. The objectives of this study were to determine a method for evaluating QT interval in cynomolgus monkeys individually, disregarding RR interval change artifacts, and to investigate prerequisite information for this method. METHODS: The physiological QT-RR relationship for practical evaluation of QT interval was recorded and analyzed by 24-hour telemetric ECG monitoring. A linear model for log-transformed QT and RR intervals was used to correct the QT interval from RR interval change artifacts for each animal. Sample size was also estimated based on the simulation results. RESULTS: Histograms showed that both QT and RR intervals had a right-heavy tail distribution. QT interval corrected individually by the linear model formula showed smaller within-animal variability than QTb and QTf, which were corrected by Bazett's formula and Fridericia's formula. The simulation results showed that the individual correction factor, beta(i), could be reliably estimated when at least 24 pairs of QT-RR baseline data were available. DISCUSSION: As with humans, QT interval in cynomolgus monkeys varies widely between individuals. Therefore, a method for correcting QT interval individually should be considered, whenever extensive untreated data are available.     

非折返房性心动过速P波形态的定位诊断

目的:通过分析房性心动过速(房速)时心电图P波形态特征判定房速起源。方法:对37例成功行单靶点消融治疗的房速患者的P波形态和参数与消融靶点进行对比分析。计算房速时PR与PP间期比值(PRI)评价激动在房室结传导的时程变化;计算P波与PR间期的比值(PCI)评价激动在房内传导的变化。结果:29例靶点位于右房,8例位于左房。左房房速在下壁导联P波振幅显著增高。右房后壁的PR(I0.52±0.05)数值在各部位中最大,无冠窦、冠状窦口和右房侧壁的PCI(0.24±0.04)值最小。结论:aVL和V1导联P波形态对区分左房和右房房速具有重要的临床意义,Ⅱ、Ⅲ、aVF导联可为起源点位于心房上下提供线索,PRI、PCI有助于房速起源的判定。     

Detection of QTc interval prolongation using jacket telemetry in conscious non-human primates: comparison with implanted telemetry

Background and Purpose: During repeat-dose toxicity studies, ECGs are collected from chemically or physically-restrained animals over a short timeframe. This is problematic due to cardiovascular changes caused by manual restraint stress and anesthesia, and limited ECG sampling. These factors confound data interpretation, but may be overcome by using a non-invasive jacket-based ECG collection (JET). The current study investigated whether a jacketed external telemetry system could detect changes in cardiac intervals and heart rate in non-human primates (NHPs), previously implanted with a PCT transmitter.Experimental Approach: Twelve male cynomolgus monkeys were treated weekly with vehicle or sotalol (8, 16, 32 mg kg⁻¹) p.o. ECGs were collected continuously for 24 hours, following treatment, over 4 weeks. A satellite group of six NHPs was used for sotalol toxicokinetics.Key Results: Sotalol attained C_max values 1–3 hours after dosing, and exhibited dose-proportional exposure. In jacketed NHPs, sotalol dose-dependently increased QT/QTc intervals, prolonged PR interval, and reduced heart rate. Significant QTc prolongation of 27, 54 and 76 msec was detected by JET after 8, 16, and 32 mg kg⁻¹ sotalol, respectively, compared with time-matched vehicle-treated animals. Overall, JET-derived PR, QT, QTc intervals, QRS duration, and heart rate correlated well with those derived from PCT.Conclusions and Implications: The current findings clearly support the use of JET to quantify cardiac interval and rhythm changes, capable of detecting QTc prolongation caused by sotalol. JET may be a preferred method compared to restraint-based ECG because high-density ECG sampling can be collected in unstressed conscious monkeys, over several weeks.