完全性右束支传导阻滞合并左后分支阻滞1例

1 临床资料 患者女性,64岁。主因发作性胸闷、憋气伴脉率缓慢为植入起搏器收入院。临床诊断:病态窦房结综合征、双束支阻滞。查体:血压16.0/11.0KPa。两肺未闻及干湿罗音及捻发音。心率60bpm,律齐,心脏各瓣膜未闻及病理性杂音。 2 心电图分析 窦性心律,心率63bpm,P—R间期0.18s,QRS电轴 110°;QRS时间0.16s,Q—T间期0.42s,QRS终     

急性非Q波前壁心肌梗死1例

患者男性,66岁。1998年7月10日以慢性肾功能不全、尿毒症期、非胰岛素依赖型糖尿病、糖尿病肾病、高血压病Ⅲ期、右眼失明收入住院。 图A(略)记录于入院前,窦性心律,Ⅱ、Ⅲ、aVF导联T波平坦,V_6导联T波双向,图B(略)记录于入院当天,与图A比较,可见R波振幅减小,Ⅲ导联由以前的rS型转为qRS型,aVF导联由Rs转为rs型,V_4导联R     

动态心电图工作指南

动态心电图能够在患者自然生活状态下连续24小时或更长时阃记录二导或多导心电信号，借助计算机进行分析处理，发现各类心律失常事件及ST段异常改变，获取重要的诊断评价依据，自60年代以来已得到广泛应用并不断发展。动态心电图的主要价值，是用以发现并记录在通常短暂心电图检查时不易发现的及日常活动时发生的心电图改变，为临床诊断和治疗提供重要依据。     

Short-term outcome of chronic heart failure with atrial fibrillation in two hospitals cohort study

Background The epidemiologic features and outcomes of chronic heart failure(CHF) patients with atrial fibrillation(AF) remain not clear in China.We aim to evaluate the epidemiologic features and outcomes of CHF patients with AF,compared by those CHF patients with sinus rhythm(SR),which is still not clear in China.Methods From January 2005 to December 2008,1161 patients were admitted to the PLA general hospitals and First Affiliated Hospital of Shantou University Medical College with a discharge diagnosis of CHF were enrolled in the study.The patients were divided into two groups according to the presence or absence of AF.The main outcomes were defined as death within one year and readmission to the hospital for heart failure.Results The rate of CHF patients with AF was 36 %.During 1 year follow-up,the overall main outcomes was higher in AF patients than in those with SR(P = 0.02).After adjusting for other covariables,including age,gender,left ventricular ejection fraction(LVEF),NYHA classification,et al,AF was no longer related to increased the risk of main outcomes during 1 year follow-up(RR:1.052,CI:0.938 ± 1.165,P = 0.629).A Cox model showed that risk of main outcomes were associated with NYHA Ⅳ(P 0.001),age(P = 0.022),left atrial dimension(P = 0.020).Conclusion The generally observed higher adverse outcome during 1-year follow-up in patients with AF thus seems to be related to other factors,such as NYHA Ⅳ,age,left atrial dimension,but not AF.     

阵发性特宽型左室侧下壁心动过速

1临床资料 男性，65岁。冠心病、陈旧性下壁、后壁及前侧壁心肌梗死。     

心血管急症救治（11）电解质紊乱的常见心电图表现及处理（续10）

心肌细胞电生理活动有赖于体液中各种电解质的浓度，电解质浓度大幅度变化将影响心肌除极及复极过程。虽然电解质紊乱可通过实验室检查确诊，但有时在某些急重症患者的处理过程中，患者的心电图有提示意义，通过心电图判断并迅速纠正电解质紊乱，可尽快稳定患者病情。     

右冠状动脉PTCA术后左束支阻滞消失1例

患者男性,50岁。因胸骨后剧烈疼痛2 h入院。临床诊断:急性下壁心肌梗死。心电图A记录于急性下壁心肌梗死3 h,冠状动脉造影显示右冠状动脉近端局限性狭窄98％。窦性心律,心率60次/min,P-R间期198ms,QRS时间146ms,Q-T间期494ms。P、R、T电轴分别为68°、-15°、-63°。Ⅰ、V_5、V_6呈单向切迹R     

对心电学从业人员进行规范化培训是建设现代化心电学强国的基础

<正>1对心电学从业人员进行规范化培训的必要性随着医学科学技术的快速发展,心电图的作用越来越重要,临床应用也越来越广泛。心电图检查从来没有像今天这样呈现出一派繁忙的景象,哪里有急诊伤病员,哪里就有心电图医师和技师;哪里有医疗活动,哪里就有心电图。没有心电图,急性心肌缺血得不到快速诊断,就没有急性冠脉综合征的分层诊断和治疗决策,不易明确胸痛的性质     

隐匿性窦房交接区早搏1例

患者男性,33岁。扩张型心肌病。附图取自清晨6时卧床记录的动态心电图CM_5导联。心电图A、B、C3条非连续记录。图A窦性P波频率95次/min,P-R间期逐搏延长后漏搏一次QRS波群,结束一次文氏周期,最小房室传导比例3:2。以后P-R间期又开始新     

远程心电监测系统的研究与应用

区域协同医疗示范工程是对国家医疗卫生服务模式创新的重大举措。作为创新国家医疗卫生服务模式的重大实践，建立现代医疗卫生保障模式——医院、社区、家庭三位一体的心电检查和监护服务系统具有非常重要的意义。利用远程医学模式和新式远程心电设备和网络技术，远程心电监护系统的应用在示范工程中将直接服务于广大百姓。