心电图、心律失常ppt课件.ppt

心电图纸上的每个小方格，横格为0.04s，纵格为0.1mv。 T波：除在avR导联是例置外，余在R波高于0.5mv时均应直立。(如在I，II导联应直立，avR中应倒置，胸前导联自V4-6均直立) Q-T间期：自QRS波开始至T波终了的间期 ,代表心室除极,复极时间的总和 Arrhythmia Arrhythmia ［教学目的、要求］ 1.了解心律失常分类 2.掌握常见心律失常的心电图表现（窦性心律及窦性心律失常，期前收缩，异位心动过速，心房扑动与心房颤动，房室传导阻滞） ［教学难点］ 常见心律失常的心电图表现 Classification SINUS RHYTHM AND  SINUS ARRHYTHMIAS Sinus rhythm features : (1) Every P wave is following by a QRS complex; (2) P wave is upright in lead I, II, aVF, V4-V6, inverse in aVR; (3)??P-R interval ≥ 0.12sec; (4) Difference of P--P interval 0.12sec in the same lead (5)??Normal rate is 60-100 beats/min Sinus Bradycardia: (1)? Sinus rhythm (2)? Heart rate 60bpm (R-R interval or P-P interval 1.0 sec ) Factors associated with sinus bradycardia (1) Physiologic Laborers and trained athletes Emotional states leading to syncope (2) Pathologic ?-blocker Hypothyroidism （甲低） Sinus Tachycardia (1)? Sinus rhythm, rate 100 bpm The R-R interval (or the P-P interval) 0.60 sec. (2)? P-R and Q-T interval are shorter than usual (3)? ST-T changes. Factors associated with sinus tachycardia (1) Physiologic Exercise Strong emotion Anxiety states (2) Pathologic Fever Hemorrhage（出血） Anemia（贫血） Myocarditis（心肌炎） Hyperthyroidism（甲亢） Sinus arrhythmia Sinus rhythm Difference of P--P interval 0.12sec in the same lead ? Sinus arrest The P wave missed for a short time Premature contractions 1. Premature Ventricular Contraction (1) Premature QRS complex is the wider and the bizarre , Duration of QRS 0.12 sec. T wave in direction is opposite to QRS complex . (2)Ventricular complex (QRS) is not preceded by a premature P wave. (3) Complete compensatory pause 2. Atrial Premature Contractions (1) The premature P wave differs in contour from the normal P wave in the same lead. (2) The P-R interval 0.12s. (3) There may be a n