二度房室阻滞伴房室干扰形成假性高度或三度房室阻滞的心电图表现
Journal of Practical Electrocardiology(2018)
Abstract
为了鉴别二度以上房室阻滞患者心电图上伴有逸搏心律时,绝大多数P波与QRS波群无关的表现究竟是真正的高度或三度房室阻滞,还是在二度房室阻滞基础上伴有干扰性房室脱节形成的假性高度或三度房室阻滞,可通过观察逸搏的R-R间期与2倍的P-P间期,以及下传P波的P-R间期,找出被阻滞P波的最长R-P间期和下传P波的最短R-P间期,再结合心房率变化时的房室传导情况加以鉴别.当心电图上出现"高度或三度房室阻滞"伴逸搏心律时,在逸搏R-R间期中有2个P波,第二个P波总是围绕在QRS波的前、中或后,逸搏R-R间期小于2倍P-P间期,且出现典型的提前心室夺获,则通常是二度房室阻滞伴房室干扰形成的假性高度或三度房室阻滞,应予以仔细鉴别.
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