心房内折返性心动过速1例

患者女性 ,５２岁。心悸、气短、胸闷１周入院。ＢＰ２１．３／１３．３ｋＰａ(１６０／１００ｍｍＨｇ) ,临床诊断 :冠心病 ,原发性高血压。同步记录动态心电图（图１）第１、２及最后一个心搏为窦性 ,ＭＶ１、ＭＶ３、ＭＶ５Ｐ波直立 ,心率６０次／ｍｉｎ ,Ｐ＿Ｒ间期０．１６ｓ ,ＳＴ＿Ｔ正常 ,Ｑ＿Ｔ间期０．３６ｓ,第３、４个心搏以房性期前收缩出现 ,Ｐ′波重叠于其前Ｔ波中 ,为成对房性期前收缩 ,第２个房性期前收缩之后连续出现５个波形相同的Ｐ′＿ＱＲＳ＿Ｔ波群 ,心率８８次／ｍｉｎ ,为房性心动过速 ,以房性期前收缩结束。动态…     

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.     

高耸T波的临床意义

一、概念 T波与心室肌动作电位3相曲线相一致,代表快速心室复极末期的电位变化。正常T波形态平滑呈半圆形,两肢不对称,前半部平缓后半部陡峭。T波方向多与QRS波群主波方向一致,     

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。     

室性早搏诱发房室结内双径路传导

室性早搏诱发房室结内双径路传导徐瑞英１卢喜烈２患者男性，５９岁。临床诊断：冠心病。心电图分析：图１Ａ为同步记录的Ｖ５、Ｖ３、Ｖ１导联心电图。窦性心律，心率１００ｂｐｍ。单个和成对出现的宽大畸形的ＱＲＳ波为室性早搏。成对的室性早搏之前Ｐ－Ｒ间期固定为１...     

房室交接区性心动过缓

一、定义 逸搏问期＞1.5s的房室交接区性搏动,称为过缓的房室交接区性逸搏(slow iunctional escape).过缓的房室交接区性逸搏连续出现3次或3次以上,称为过缓的房室交接区性逸搏心律(slow iunctional escape rhythm),或称房室交接区性心动过缓(iunctional bradycardia).     

心电网络系统

一、基本概念 心电网络系统是通过计算机网络把分布在医院各科和各心电图室的心电图机、动态心电图系统、运动负荷系统、监护病房及手术全程监测过程中的心电信息网络至医院信息化管理系统（HIS）。在医院的信息化管理系统工作站中运行,实现心电图申请预约、检查流程化、自动化、心电图报告集中储存和随时调阅。     

冠状动脉架桥围术期合并急性下壁心肌梗塞1例报道

患者男,65岁。劳累后发作性心前区疼痛4个月,加重1周入院。开始于每次劳累后发作心前区疼痛,3分钟后缓解,以后上述症状反复发作多次。查体:BP20.0/10.0kPa(150/75mmHg),冠状动脉造影显示三支病变:前降支近端50％狭窄,远端80％狭窄,回旋支中段完全闭塞,右冠状中段80％狭窄,远端90％狭窄。6天后在低温体外循环下行右冠状动脉回旋支、前降支三支搭桥手术,术后1小时患者发生持续性胸骨后疼痛。临床诊断:围术期急性下壁心肌梗塞。     

房性并行心律伴窦房折返1例

患者男性,68岁。临床诊断:冠心病。附图为V_1导联,见窦性P波规律出现,频率61次/分,Pv_1呈双向,P-R间期0.18秒,并可见异位P′波规律出现,联律间期不等,P′-P′间期为1.12—3.52秒,长P′-P′间期约为短P′-P′间期的3倍,可考虑为房性并行心律,并行灶频率稍有不齐。P′_3后无代偿,表现为间位性,但包含房性P′波的2个窦性P波间期(0.88抄)小于1个正常窦性周