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患者女性,69岁,临床诊断:扩张型心肌病,冠心病,病态窦房结综合征.心电图Ⅰ导联(附图)示窦性心律,频率14次/min.P_1直立,从P_2开始P波变低平,同时P-R由0.18s延长到0.23s(R_3),为窦房结内游走心律.R_(1、2)为窦性,呈宽钝R型,QRS时间0.12s,为完全性左束支阻滞型.R_(5-7)前无相关P波,QRS是完全性右束支阻滞型,R-R匀齐,频率46次/min,为室性逸搏心律,R_(3、4)前有相关P波.且R_5-R_1、R_1-R_5间距符合室性逸博周期长度,R_(?)、R_1应为窦性与室性逸搏的室性融合波.R_(?)QRS呈较正常的窄R型,考虑逸搏点在左束支阻滞区之下,逸
Patient female, 69 years old, clinical diagnosis: dilated cardiomyopathy, coronary heart disease, sick sinus syndrome. ECG lead Ⅰ (with photos) shows sinus rhythm, the frequency of 14 times / min.P_1 upright, starting from P_2 P The wave became lower and flat, meanwhile, PR prolonged from 0.18s to 0.23s (R_3), which was the walking heart rhythm in the sinoatrial node.The R_ (1,2) was sinus, wide and blunt R-shaped, QRS time was 0.12s, There was no correlated P wave before R_ (5-7), QRS was complete right bundle branch block (RRB), RR was homogeneous and the frequency was 46 beats / min. 3, 4) before the relevant P wave. And R_5-R_1, R_1-R_5 spacing consistent with the length of ventricular escape function cycle, R _ (?), R_1 should be ventricular sinus rhythm and ventricular fusion .R_ QRS was narrower than the normal type R, taking into account the escape point in the left bundle branch block, Yi