aVR 导联及其特殊位置对冠心病诊断的意义

aVR 导联在额面导联体系中位于右上肩，可俯瞰整个心室腔，故被称为心室腔导联。它可记录整个心内膜的电活动，对冠心病的诊断具有重要意义，特别是对冠脉左主干病变及多支血管病变等的诊断价值均高于其他单个或多个导联。而位于 aVR 导联对侧的“－aVR”导联使额面导联系统能按心脏的空间激动顺序进行排列，更符合逻辑和心脏激动的顺序，使下壁和高侧壁扩展的急性心肌梗死的诊断成为可能。本文结合国外近年来的研究文献对 aVR和“－aVR”导联的临床应用进行综述。

Diagnostic value of special orientation of lead aVR for coronary heart disease

Lead aVR is located on upper right shoulder in frontal plane lead system,overlooking the whole ventricular chamber,and therefore it is called cavity lead.The electrical activity of the whole en-docardium can be recorded by lead aVR,which is important for the diagnosis of coronary heart disease. Its diagnostic value is higher than any other unipolar lead or multiple leads,especially for left main coro-nary artery (LMCA)obstruction and multivessel disease,etc.The contralateral lead of lead aVR,lead“-aVR”arranges frontal plane lead system in order of spatial excitation sequence of the heart.It is more logical and is coincident with the excitation order of the heart,which makes it possible to diagnose inferior wall and high lateral wall acute myocardial infarction.This paper reviews on the clinical applica-tion of lead aVR and “-aVR”,combined with overseas literatures in recent years.