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临床资料及心电图分析患者女性,54岁,糖尿病、慢性肾炎、病态窦房结综合征。一年前安装“秦明8619”ⅤⅥ起搏器,起搏效果甚佳。1991年5月1日突然发生脑溢血,12个小时后死亡。本文附图A、B是死亡前5小时仿Ⅰ、Ⅲ两个导联非同步记录。心室起搏频率72ppm,脉冲信号全部带动心室,并产生1:1的室房传导(A图QRS后的P~-较明显)。QRS后有T-U双峰波形,U皆高于T,但U波呈高宽和矮窄交替出现。Q-T-U时间明显延长,高宽U波出现时,Q-T-U超越整个心动周期,即下一心室刺激电信号落在U波的后支末。本帧心电图诊断:①右心室起搏心电图;②右室起搏伴1:1室房传导;③U>T,Q-T-U间期明显延长;④心室起搏伴U波电交替(Ventricular pacing and electrical alternans of U wave)。
Clinical data and ECG analysis of female patients, 54 years old, diabetes, chronic nephritis, sick sinus syndrome. A year ago to install “Qin 8619” Ⅴ Ⅵ pacemaker, pacing effect is very good. May 1, 1991 sudden stroke, 12 hours after the death. Attached Figure A, B is 5 hours before death imitation Ⅰ, Ⅲ two lead unsynchronized records. Ventricular pacing frequency of 72ppm, pulse signals all lead to ventricular and produce 1: 1 room conduction (A Figure QRS after P ~ - more obvious). After QRS T-U bimodal waveform, U are higher than T, but the U-wave height and width were alternating with short and narrow. Q-T-U time was significantly extended, high-bandwidth U wave appears, Q-T-U exceeds the entire cardiac cycle, the next ventricular stimulation signal falls in the U wave of the posterior branch. The frame of ECG diagnosis: ① right ventricular pacing ECG; ② right ventricular pacing with 1: 1 room conduction; ③ U> T, QTU interval was significantly prolonged; ④ ventricular pacing with U wave alternation (Ventricular pacing and electrical alternans of U wave.