心电图详解__培训课件.ppt

* * 第五步 : 看T波 方向：多与QRS波群主波方向一致， Ⅰ、Ⅱ、V4～V6导联向上，aVR向下， 若V1T波向上，则V2～V6导联就不应再向下振幅：多 ? 1/10 R 第六步 : 看QT间期 从Q波起点至T波终末代表心室肌除极和复极全过程 所需时间 正常：0.32 —0.44s 正常窦性心律 窦性静止 窦性静止 窦性静止 正常窦性心律 房性早搏 房性早搏 正常窦性心律 房性早搏 房速 正常窦性心律 房颤 房扑 正常窦性心律 房性早搏 房室交界性早搏 正常窦性心律 房室交界性早搏 阵发性室上性心动过速 正常窦性心律 房性早搏 房室交界性早搏 I度房室传导阻滞 I I度房室传导阻滞 正常窦性心律 房性早搏 房室交界性早搏 I I度房室传导阻滞（I型） II度房室传导阻滞（II型） 正常窦性心律 I I I度房室传导阻滞 I I I度房室传导阻滞 正常窦性心律 阵发性室性心动过速 室速 室性早搏 室性早搏 正常窦性心律 窦性静止 扭转性室速 室速 正常窦性心律 窦性静止 室速 正常窦性心律 阵发性室性心动过速 室性早搏 恶性室性早搏RonT 恶性室性早搏 1．右束支传导阻滞（right bundle branch block，RBBB）由于右束支细长，单侧冠脉分支供血，不应期比左束支长，故较左束支更容易发生阻滞。可以发生在各种器质性心脏病，也可见于健康人。 心电图表现：(1)QRS时间增宽≥0.12s。(2)V1导联 呈rsR’型，V5、V6 导联呈qRS形，S 波宽阔。(3) V1、V2导联ST-T方向与主波方向相反。 【异常心电图】右束支传导阻滞 完全右束支传导阻滞心电图特点： V1、V2导联呈rSR′型或宽大而有切迹的R波。 V5、V6导联呈qRS或RS型，S波深宽。 QRS时限大于0.12秒。 继发性ST—T改变 PtfV1 signifies a terminal force of the left atrium, which is recorded on an EKG as a negative P wave of lead V1.? A normal P wave is either positive or double directed.? In the double directed wave a negative wave follows a positive wave.? The index of PtfV1 is a product of the negative amplitude and its duration in the P wave.? Research has shown that PtfV1 indicates: 1) an enlarged inner diameter of the left atrium, 2) decreased left ventricular compliance, and 3) reduced diastolic function of the left ventricle. A clinical study was performed on patients with left ventricular hypertrophy due to hypertension, in order to examine the correlation between the PtfV1 index and the degree of heart-qi deficiency. * * * * PtfV1 signifies a terminal force of the left atrium, which is recorded on an EKG as a negative P wave of lead V1.? A normal P wave is either positive or double directed.? In the double directed wave a negative wave follows a positive wave.? The index of PtfV1 is a product of the negative amplitude and its duration in the P wave.? Research has shown that PtfV1 indicates: 1) an enlarged inner diameter of the left atrium, 2) decreased left ventricul