aVL和aVR导联在室上速鉴别中的意义

目的对比研究a VL导联和a VR导联在鉴别室上性心动过速中的意义。方法选取我院2010年6月至2014年6月因心动过速就诊并经心脏电生理检查及射频消融证实为慢快型房室结折返性心动过速（SF-AVNRT,n=58）或顺向性房室折返性心动过速（AVRT,n=74）患者132例,与窦性心律相比,观察a VL导联切迹和a VR导联假性r波或粗顿的发生率。结果 AVNRT和AVRT中a VL导联出现切迹的发生率为53.4%和8.1%（p〈0.05）,差异有统计学意义,AVNRT和AVRT中a VR导联出现假性r波或粗顿的发生率为72.4%和6.8%（p〈0.05）,a VL切迹和a VR假r波或粗顿在AVNRT中的发生率53.4%和72.4%（p〈0.01）,差异有统计学意义。结论 a VL切迹和a VR导联假性r波均常见于AVNRT,有助于AVNRT的鉴别诊断,而a VR导联具有更高的敏感性。

The comparative study of aVL lead and aVR lead in the identification of PSVT

Objective To comparative study a VL lead and a VR lead in the identification of PSVT. Methods132 cases were performed by RFCA with SF-AVNRT 58 cases and AVRT 74 cases, compared with sinus rhythm,observe the incidence of a VL-lead notching and a VR-lead pseudo r wave. Results The incidence of a VL-lead notching in AVNRT and AVRT were 53.4% vs. 8.1%（p 0.05）, the incidence of a VR-lead pseudo r wave in AVNRT and AVRT were 72.4% vs. 6.8%（p〈0.05）, the incidence of a VL-lead notching and a VR-lead pseudo r wave in AVNRT were 53.4% vs. 72.4%（p〈0.01）. Conclusions a VL-lead notching and a VR pseudo r wave were significant in AVNRT. Contribute to the differential diagnosis of AVNRT and a VR-lead has a higher sensitivity.