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目的探讨起源于希氏束旁的右室特发性室性心动过速/室性期前收缩(VT/VPCs)的心电图和电生理特征。方法入选3例起源于希氏束旁的右室特发性VT/VPCs患者,行12导联心电图及心内电生理检查,并行射频导管消融治疗。结果3例患者消融靶点记录到较清晰的希氏束电位,VT/VPCs下希氏束局部心室电位领先于体表心电图的QRS波群。所有患者I导联QRS波群均呈现单相高R波,aVL导联QRS波群均呈现R波,Ⅲ和aVF导联R波振幅明显低于Ⅱ导联,V1导联呈左束支阻滞形,VT/VPCs时QRS波群宽度较窄。结论起源于希氏束旁的VT/VPCs具有特征性的心电图表现,掌握这些特点有助于VT/VPCs的术前定位及提高导管消融的成功率。
Objective To investigate the ECG and electrophysiological characteristics of right ventricular premature ventricular tachycardia / ventricular premature contraction (VT / VPCs) originating from His bundle. Methods Three patients with right ventricular idiopathic VT / VPCs originating from His bundle were enrolled in this study. The 12-lead electrocardiogram and intracardiac electrophysiology were performed and radiofrequency catheter ablation was performed. Results The ablation targets of three patients recorded a clear His bundle potential, and the local prenatal potential of His bundle under VT / VPCs was ahead of the QRS complex of the body surface electrocardiogram. All patients with QRS wave of I lead showed single-phase high R wave, aVL lead QRS wave group showed R wave, Ⅲ and aVF lead R wave amplitude was significantly lower than Ⅱ lead, V1 lead was left bundle branch resistance Hysteresis, VT / VPCs QRS complex wave width narrow. Conclusions VT / VPCs originated from His bundle have characteristic electrocardiographic findings. To master these features is helpful for the preoperative localization of VT / VPCs and the success rate of catheter ablation.