DIFFERENTIAL MORPHOLOGY OF ANOMALOUS VENTRICULAR COMPLEXES OF RBBB-TYPE IN LEAD V1 - VENTRICULAR ECTOPY VERSUS ABERRATION
DIFFERENTIAL MORPHOLOGY OF ANOMALOUS VENTRICULAR COMPLEXES OF RBBB-TYPE IN LEAD V1 - VENTRICULAR ECTOPY VERSUS ABERRATION
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DOI：
10.1161/01.cir.31.4.551
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发表时间：
1965-01-01
期刊：
影响因子：
37.8
通讯作者：
MARRIOTT, HJ
中科院分区：
文献类型：
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作者：
SANDLER, IA;MARRIOTT, HJ
区分异位心室搏动和心室传导异常（AVC）具有实际的诊断和治疗意义；但鉴别可能是困难的或不可能的，特别是在心动过速或心房颤动的存在。由于绝大多数异常心跳表现为右束支传导阻滞（RBBB）模式，因此本研究仅限于在六导联中表现或模拟RBBB的异常复合物。我们分析了三组异常心室复合物的形态，以寻找经验差异：1) 50例早期室上搏动显示AVC为RBBB形式；2)100例固定RBBB； 3) 100例异位心室搏动显示“RBBB”轮廓；70%的异常搏动和67%的RBBB记录显示三相（rsR[image]、rsR[image]或rsR[image]）模式，而只有6%的异位心室搏动是三相。各组剩余复合物多数为单相(R)或双相（qR、qR、qu或RS）。在异常心跳中，44%显示与相关正常心跳相同的初始矢量为0.02，而只有4%的异位心室跳动显示明显不变的初始矢量。因此可以得出结论：(1)室性脑室的三相模式有利于诊断失常，而单相或二相模式在较小程度上有利于诊断室性脑室异位；(2)虽然改变的初始向量在区分异位和畸变方面价值不大，但相同的初始向量提供了支持畸变传导的有力证据。
The distinction between ectopic ventricular beats and aberrant ventricular conduction (AVC) is of practical diagnostic and therapeutic importance; but the differentiation can be difficult or impossible, especially in the presence of tachycardia or atrial fibrillation. Since the great majority of aberrant beats show a right bundle-branch block (RBBB) pattern, this study is restricted to anomalous complexes showing or simulating RBBB in lead VI. The morphology of 3 groups of anomalous ventricular complexes has been analyzed for empirical differences: 1) 50 early supraventricular beats showing AVC of RBBB form, 2) 100 examples of fixed RBBB 3) 100 ectopic ventricular beats showing a "RBBB" contour 70% of the aberrant beats and 67% of the RBBB records showed a triphasic (rsR[image], rSR[image], or rsr[image]) pattern, whereas only 6% of the ectopic ventricular beats were triphasic. Most of the remaining complexes in each group were monophasic (R) or diphasic (qR, QR, qu, or RS). Of the aberrant beats 44% showed aninitial 0.02 vector identical with that of the associated normally conducted beats, whereas only 4% of the ectopic ventricular beats showed an apparently unchanged initial vector. One may therefore conclude that (1) triphasic patterns in VI favor the diagnosis of aberration, whereas monophasic or diphasic patterns to a lesser extent favor the diagnosis of ventricular ectopy; and (2) although a changed initial vector is of little value in distinguishing between ectopy and aberration, an identical initial vector provides strong evidence in favor of aberrant conduction.