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目的探讨无人区心电轴在宽QRS波心动过速(WCT)中的鉴别诊断价值。方法收集并测量北京大学人民医院2000年1月至2005年10月经心内电生理检查明确诊断的WCT患者窦性心律及心动过速时心电图中Ⅰ、Ⅲ标准导联QRS波振幅的代数和,计算QRS波额面平均心电轴,观察无人区心电轴出现的心律失常类型及规律。结果137例[其中特发性室性心动过速(IVT)65例,室上性心动过速(室上速,SVT)72例]明确诊断的WCT患者中,18例出现无人区心电轴,其中室性心动过速(室速)16例(占室速24.6%,占总病例11.7%),均为左心室特发性室速;宽QRS波室上速2例(占宽QRS波室上速2.8%,占总病例1.5%),均为心房颤动(房颤)伴左侧旁路前传。结论无人区心电轴可以作为鉴别室速与宽QRS波室上速的一项可靠指标。
Objective To explore the value of unmanned electrocardiography in the differential diagnosis of wide QRS tachycardia (WCT). Methods Algebraic sum of QRS amplitudes of Ⅰ and Ⅲ standard leads in sinus rhythm and tachycardia of WCT patients diagnosed by transcardiac electrophysiological examination in Peking University People’s Hospital from January 2000 to October 2005 were collected and measured. Calculate the average QRS wave frontal axis, to observe the absence of arrhythmia cardiac arrhythmia type and regularity. Results Of 137 patients with idiopathic ventricular tachycardia (IVT), 65 patients with supraventricular tachycardia (SVT), 72 patients were diagnosed with WCT, 18 patients had uninhabited electrocardiogram Axis, including ventricular tachycardia (ventricular tachycardia) in 16 cases (24.6%, accounting for 11.7% of the total cases), were left ventricular idiopathic VT; wide QRS wave velocity in 2 cases (wide QRS 2.8% supraventricular tachycardia, 1.5% of the total cases), atrial fibrillation (atrial fibrillation) with left anterior descending. Conclusion The unoccupied cardiac electrical axis can be used as a reliable indicator of ventricular tachycardia and wide QRS wave velocity.