显性房室旁道对心室除极波终末向量变化的影响

目的 探讨显性房室旁道对心室除极波终末向量的影响.方法选择经射频消融(RFCA)术证实的显性单房室旁道102例及隐匿性单房室旁道38例患者,经临床常规检查元器质性心脏病.将房室旁道分为后间隔(PS)、中间隔(MS)、前间隔(AS)、左后游离壁(LP)、左前游离壁(LA)、右后游离壁(RP)及右前游离壁(RA)房室旁路.结果102例显性房室旁道患者射频消融术后终末向量全部发生改变,38例隐匿性房室旁道中的4例射频消融术后终末向量发生改变,34例无变化.显性房室旁路与隐匿性房室旁路相比差异有统计学意义(P<0.05).不同部位间的显性旁路相比差异无统计学意义(P>0.05);终末向量的变化具有导联特异性.结论显性房室旁道可以改变心室除极终末向量,并且这种变化具有导联的特异性.

Effect of dominant accessory atrioventricular pathways on QRS complex terminal vector

Objective To analyze the effect of dominant accessory atrioventricular pathways (AP) on the end vector of ventricular depolarization. Methods All patients had single AP confirmed by radiofrequency cathteter abalation (RFCA) and were free from organic heart disease (including 102 cases of dominant accessory AP and 38 cases of concealed AP). The AP was divided into posterior septal(P3) ,mediate septal (MS) ,anterior septal (AS), left posterior free wall (LP), left anterior free wall (LA), right posterior free wall (RP) and right anterior free wall (RA). Results The end 40 ms vector of QRS wave changed in 102 patients with manifested AP and in 4 patients with concealed AP (P < 0. 05). Conclusion The end 40 ms vector of QRS wave of any site manifested AP can change and the changes have the specihty of leads.