简介:摘要目的探讨II、III、aVF导联碎裂QRS波(fQRS)在急性肺栓塞患者肺动脉压分层中的临床意义。方法回顾性分析96例肺栓塞患者心电图的fQRS波,比较下壁与前壁、侧壁导联fQRS波发生率,以及下壁导联fQRS波与肺栓塞患者肺动脉高压的关系。结果下壁导联fQRS波发生率显著高于前壁和侧壁。在下壁导联fQRS阳性的肺栓塞患者中,肺动脉高压的发生率较高。结论肺栓塞患者中,下壁出现fQRS波的机会较前壁和侧壁为多,且与肺动脉高压相关。
简介:目的探讨慢性心衰患者QRS时程(QRSd)增宽对新发房颤的预测价值.方法选择患有心衰但无房颤病史的患者1098例,将其分为三组:QRSd≤120ms、120ms〈QRSd〈150ms及QRSd≥150ms组,随访跟踪各组新发房颤的概率.通过二元分析和多元logistic回归分析探讨QRS时程和房颤新发概率之间的相关性.结果对患者群体的统计表明,房颤的新发概率为35.7%.通过二元分析发现,房颤的新发概率存在组间差别(21.7%、35.9%、42.5%,P〈0.01);进一步通过多元回归发现,QRS时程是独立的影响因素.结论QRS是慢性心衰患者新发房颤的独立预测因素.
简介:Objective:Toinvestigatetheinfluenceofdifferentrightventricular(RV)pacingsitesonQRSwidth,andtoprovideapotentialreferencesiteforpermanentrightventricularpacinginpatientsimplantedwithpermanentpacemakers.PacingatthesitewiththeshortestQRSdurationmayreducethedeleteriouseffectsofRVpacingonLVfunction,andthushavingbeneficialeffectsonpatient’soutcome.Methods:AllconsecutivepatientswhowereplannedtohavepermanentpacemakerimplantationforaClassIorIIaindicationatourdepartmentfromOctober2010toJuly2012werescreenedfortheparticipationinthisprospective,singlecenter,non-randomizedstudy.ThebaselinesurfaceECGwasanalyzedforQRSwidthandmorphology,respectively.DuringtheimplantationprocedurepatientsweretransientlypacedatdifferentRVlocations(rightventricularapex,rightventricularinflowtract[RVIT],midseptum,highseptumandrightventricularoutflowtract[RVOT])beforetheleadwasplacedatitsfinalposition.Duringpacingatthedifferentpositionsthesurface12-leadsECGwasrecorded.BasedonthesurfaceofECGQRSdurationandmorphologyofthedifferentrightventricularpacingsiteswereanalyzedandcomparedwithbaselineandtoeachother.Results:Atotalof216patients(39%female,meanage69±13years,higherdegreeAVblock30.5%)wasenrolledinthestudy.PacedQRSdurationwassignificantlydifferentbetweenallrightventricularpacingsitescomparedwiththebaselineECG(baseline:106ms±21ms;meanpaced:158ms±16ms;p<0.001).RVApacingshowedthewidestQRS(168ms±16ms).QRSdurationwithRVITpacingwas166ms±15ms,andthatwithRVOTpacingwas165ms±15ms,respectively.QRSdurationwasnotsignificantlydifferentbetweenthesethreepositions.Mid-septalpacingshowedthenarrowestQRS(139ms±19ms)comparedtoallotherpacingsites(p<0.001).Pacingatthehigh-septumshowedabroaderQRS(153ms±14ms)thanthatpacingatthemid-septum.Comparedtootherrightventricularpacingsites