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研究V1导联左束支阻滞QRS波形的早期表现 ,以及左束支阻滞从不完全性到完全性在V1导联QRS波形的演变规律和影响功能性左束支阻滞显现的因素。 10 0例经食管心房程序刺激显现的具有直接显示性左束支文氏阻滞特征的功能性左束支阻滞病人与 10 0例无功能性束支阻滞的正常者作对比研究。结果 :①功能性左束支阻滞的检出率为 6 .73% ;②V1导联左束支阻滞的早期QRS波形的表现为SV1增深。左束支阻滞从不完全性到完全性在V1导联QRS波形的演变规律为正常rS—深S波的rS—窄QS—宽QS ;③功能性左束支阻滞的房室交界区功能不应期略短于左束支有效不应期 ,而房室交界区相对不应期、功能不应期则显著短于对照组 (5 4 2± 95msvs 5 74±6 4 .1ms,4 15± 5 1.4msvs 4 4 1± 5 1.7ms ,P <0 .0 1)。结论 :左束支阻滞从不完全性到完全性在V1导联上可呈现其演变规律。
To investigate the early manifestation of QRS waveform of left bundle branch block in lead V1 and the evolution of left bundle branch block from incompleteness to completeness in QRS waveform of lead V1 and the factors affecting the appearance of functional left bundle branch block. One hundred and ten patients with functional left bundle branch block with direct manifestations of left bundle branch block presented by esophageal atrial stimulation were compared with 100 normal controls without functional bundle branch block. Results: ① The detection rate of functional left bundle branch block was 6.73%. ② The early QRS waveform of left bundle branch block in V 1 lead to SV1 deepening. Left bundle branch block from incomplete to complete V1 lead QRS waveform of the evolution of the rS-narrow S-narrow QS-wide QS of normal rS-deep S wave; ③ functional left bundle branch block atrioventricular junction The functional refractory period was slightly shorter than the effective refractory period of the left bundle branch, whereas the atrioventricular junctional relative refractory period and functional refractory period were significantly shorter than the control group (542 ± 95 ms vs 5 74 ± 6.41 .1 ms, 4 15 ± 5 1.4msvs 4 4 ± 5 1.7ms, P <0.01). CONCLUSIONS: The incompleteness to completeness of the left bundle branch block may present its evolution in V1 lead.