摘要
10例心律失常患者同步记录腔内窦房结电图(SNE_c)、体表窦房结电图(SNE_b)和EKG或高位古房电图(HRAE),发现SNE_b与SNE_c结果一致。窦律时SNE_c与SNE_b的A波前均有P前波,形态相似,体表窦房传导时间(SACT_b)与腔内窦房传导时间(SACT_c)高度相关(r=0.96,P<0.005);心脏起搏点移位时,SNE_c与SNE_b的A波前均无P前波,同时A波形态改变。SNE_c的P前波只在上腔静脉、右心房交界处窦房结解剖部位记录到,右心房的其它部位记录不到,在无心室活动的A-A波间,SNE_b、SNE_c的A波前仍有P前波;交界性逸搏V波前则无P前波。结论:SNE_c的P前波是窦房结电位,SNE_b与SNE_c的P前波系同一来源,是窦房结电活动在不同记录部位的反映。SNE_b无创伤,方法简便,可代替SNE_c在临床使用。
The body surface sinus node electrogram (SNEb) andendocardiac sinus node electrogram (SNEc), EKG or high right atrium electrogram(HRAE) were simultaneously recorded in 10 cases. The pre-P wave prior to eachA wave in both SNEb and SNEc was synchronally recorded. In sinus rhythm, thechar-acteristics of pre-P wave of SNEb and SNEc were similar. Both SACTc andSACTb were significantly correlated (r=0.96,P<0.005). When cardiac pace-makershifted, the pre-P wave diaappeared in both SNEb and SNEc, and the shape of Awave changed. The pre-P wave of SNEc was only recorded at the junction ofsuperior vena cava and right atrum, while over other area of right atrium no pre-Pwave could be recorded. Between two A wave intervals which had no ventricularelectric activity, there was pre-P wave prior to A wave, but there was no pre-Pwave before junctional escape beat. Pre-P wave of SNEc is sinus node potential,the pre-P wave of SNEc and SNEb comes from the same origin, they aredifferent reflection in various area of sinus node electric activity, SNEb mayreplace SNEc used in clinical practice.
关键词
心电图
病窦综合征
窦房结电图
sinoatrial node
sick sinus syndrome
sinus node electrogram
