徐冬梅心律失常演示文稿正式讲稿课件.ppt

2. 左束支阻滞 　完全性: QRS时限≥0.12s,V5 V6R波宽大顶部有切迹或粗顿,其前方无q 波, V1V2 呈宽阔QS型或rS型,T波与QRS主波方向相反. 不完全性: QRS时限0.12s 完全性左束支传导阻滞 V1，V2导联呈现宽大而深的rS或QS波；V5，V6导联一般无q波及S波、R波宽大、粗纯或有切迹。ⅠavL导联与V5、V6导联相似 QRS波≥0.12秒，VATV5、V6≥0.06 ST-T方向与QRS主波方向相反 3. 左前分支阻滞 4. 左后分支阻滞 二、治疗 　慢性者，多无需治疗；而急性心梗发生双分支、三分支阻滞，或慢性双分支、三分支阻滞伴有阿斯发作者，需及早安装起搏器。 左前分支阻滞 左后分支阻滞 致 谢 * * AV block can be described as a prolongation of the PR interval. The PR interval is the interval from the onset of the P wave to the onset of the QRS complex. First-degree AV block is defined by a PR interval greater than 0.20 seconds (200 msec). First-degree AV block can be thought of as a delay in AV conduction, but each atrial signal is conducted to the ventricles (1:1 ratio). * Second-degree AV block is characterized by intermittent failure of atrial depolarizations to reach the ventricle. There are two patterns of second-degree AV block. The first, Type I, is marked by progressive prolongation of the PR interval in cycles preceding a dropped beat. This is also referred to as Wenckebach or Mobitz Type I block. The AV node is most commonly the site of Mobitz I block. The QRS duration is usually normal. * Mobitz Type II second-degree AV block refers to intermittent dropped beats preceded by constant PR intervals. To differentiate Mobitz I from Mobitz II, note the PR interval in the beats preceding and following the dropped beat. If a difference between these two PR intervals is more than 0.02 seconds (20 msec), then it is Mobitz I. If the difference is less than 0.02 seconds, then it is Mobitz II. The infranodal (His bundle) tissue is most commonly the site of Mobitz II block. Note: Advanced second-degree block refers to the block of two or more consecutive P waves (i.e., 3:1 block). 间位性室性期前收缩 室性期前收缩出现于两个正常窦性搏动之间，无代偿间期 多形性室性期前收缩 同一导联内，室性期前收缩形态不同者称多形性或多源性室性期前收缩 室性并行心律 配对间期不恒定 长的两个异位搏动间