一种不规则的宽QRS复合节律

S. Pagano
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引用次数: 0

摘要

前两次和最后一次有清晰可见的窦性P波(图1中用*标记)。从第三次搏动开始出现不规则的宽QRS波群节律,左束支传导阻滞(LBBB)形态,无可见P波。尽管LBBB可能提示室上性心律,但第二次搏动是融合复合波,揭示了宽QRS复合波心律的心室起源。事实上,在准确的分析中,与前一次相比,第二次搏动具有更短的PR间期和不同的QRS形态(例如,在DI导联中,它是完全正的,并且与异相和窄的前一次比较稍微宽)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An Irregular wide QRS Complex Rhythm
There are clearly visible sinus P-waves in the first two beats and in the last one (marked with * in Figure 1). From the third beat an irregular wide QRS complex rhythm with left bundle branch block (LBBB) morphology begins, without visible P-waves. Although the LBBB may suggest a supraventricular rhythm, the second beat is a fusion complex, revealing a ventricular origin of the wide QRS complex rhythm. On an accurate analysis indeed, the second beat has shorter PR interval and a different QRS morphology compared to the previous one (in DI lead for example it is entirely positive and slightly wider comparing to the previous one which is isodifasic and narrow).
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