左后分支型宽 QRS 波心动过速临床特征及药物治疗分析.pdfVIP

·816 · 西南国防医药2014年8月第24卷第8期 左后分支型宽 QRS波心动过速临床特征及药物治疗分析 戴 庆，白 剑，李晓宏，张必利 ［摘要］ 目的 探讨左后分支型宽QRS波心动过速的临床特征及对药物治疗的反应。方法 收集14 例体表心电图呈 左后分支型宽QRS波心动过速患者的临床资料，包括病史、心电图特征、电生理检查结果及其对抗心律失常药物治疗的反应。 结果 14例发作时胸导联QRS均呈右束支阻滞图形，电轴均左偏或指向无人区。其中13例经电生理检查或心电图确诊为室 速，1例不能确定为室速或室上速；12例曾接受维拉帕米治疗，均能成功终止发作。结论 急诊终止左后分支型宽QRS波心 动过速发作可首选维拉帕米治疗。 ［关键词］ 宽QRS波；心动过速；维拉帕米；心电图 中图分类号 R541.7 文献标识码 A 文章编号 1004-0188（2014）08-0816-03 doi：10.3969/ .issn.1004-0188.2014.08.002 Clinical characteristics of left posterior fascicular type wide QRS tachycardia and drug therapy analysis 1 1 1 2 Dai Qing ，Bai Jian ，Li Xiaohong ，Zhang Bili 1. Department of Cardiology，Drum Tower Hospital Affiliated to Medical School， Naning University，Naning，Jiangsu，210008，China；2.Department of Cardiology，Changhai Hospital Affiliated to the Second Military Medical University，Shanghai，200433，China ［Abstract］ Objecti e ToinvestigateclinicalcharacteristicsofleftposteriorfasciculartypewideQRScomplextachycardiaand the response of the patients to drug therapy.Methods The clinical data of 14 cases with left posterior fascicular type wide QRS complex tachycardia were collected and analyzed，including case history，surface ＥCG features，electrophysiological findings and responses toantiarrhythmicdrug.Results 14 patientsshowedepisodesofrightbundlebranchblockQRSpatterninchestleadsofＥCG with axis pointing to left side or to no man′s land，out of them，13 patients were finally diagnosed to have ventricular tachycardia by electrophysiological examinationorＥCGand1casewasfailedinconfirmingtohavewhetherventricularorsupraventriculartachycardia； verapamil therapy was performed on 12 patients and the attacks were successfully terminated.Conclusions Verapamil therapy is the first-choicefor the emergent termination of left posterior fascicular typewide QRS complex tachycardia. ［Key words］ wide QRS；complex；tachycardia；verapami