射频消融显性房室旁道对心电图额面电轴和横面移行区的影响

目的探讨射频消融(RFCA)显性房室旁道对心电图额面电轴和横面移行区的影响。方法选择经RF-CA术证实的显性单房室旁道86例及隐匿性单房室旁道30例患者为研究对象。将房室旁道分为左前壁(LA)、左后壁(LP)、左侧壁(LL)、右前侧壁(RAL)、右后侧壁(RPL)、右侧壁(RL)、前间隔(AS)、中间隔(MS)及后间隔(PS)房室旁道。对比分析RFCA术前、后心电图。观察RFCA术前、后额面电轴的改变或/和横面移行区的移位。结果①30例隐匿性房室旁道患者RFCA后,心电图额面电轴无一例发生变化,横面移行区2例发生变化,28例无变化。②86例显性房室旁道患者RFCA术后,心电图额面电轴和/或横面移行区均发生改变。LL、LA旁道心电轴右移(P0.01);LP、RL、RPL、MS及PS旁道心电轴左移;RAL、AS旁道术前、术后心电轴无差异(P0.05)。结论显性房室旁道可引起心电图额面电轴和横面移行区的变化,且改变特点与旁道部位有关。

Effect of manifested atrioventricular pathways on the frontal QRS axis and horizontal transitional zone

Objective To analyze the effect of manifested atriventricular accessory pathways （AP） on the frontal QRS axis and horizontal transitional zone. Methods One hundred and sixteen patients had single AP confirmed by radiofrequency catheter ablation（RFCA） ,including 86 cases of manifested AP and 30 cases of concealed AP. According to the site of the AP, the manifested AP was divided into left anterior（ LA）, left posterior（ LP）, left lateral（ LL）, right anterior lateral（ RAL）, right posterior lateral（ RPL）, right lateral（ RL）, posterior septal（ PS）, mediate septal（MS） and anterior septal （AS）. The changes of the frontal QRS axis and horizontal transitional zone were observed before and after RFCA. Resuits （1）There are no changes in the frontal QRS axis of the 30 patients with concealed AP. Horizontal transitional zone changed in 2 female patients with concealed AP. （2）The frontal QRS axis and/or horizontal transitional zone changed in 86 patients with manifesteded AP. and in 2 female patient with concealed AP. Conclusions Manifesteded AP can change the frontal QRS axis and horizontal transitional zone and the changes are related to the AP site. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2010,24（2） ：149 - 151 ]