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为总结ASD心电图表现和Amplatzer双面伞闭合术后1周内心电图改变,对152例肺总阻力正常、Qp/Qs=1.5～3.0的单纯ASD进行心电图观察,并对比观察心电图表现与ASD大小及年龄的关系。结果显示:①QRS电轴右偏和不偏分别为52%和47.4%,左偏罕见(0.6%)。V_1(V_3R)多呈右束支阻滞图型(67.1%),其次为rS图型(28.3%),Rs的右心室肥厚型少见(4.6%),未见qR型。TV_(5-6)倒置占7.3%,严重心律失常少见(3例心房颤动);②大ASD(≥25mm)右心负荷较中小ASD(<25mm)明显增重(P<0.005),其负荷与年龄无显著关系,但呈CRBBB图型者均>30岁,心房颤动者均>40岁;③Amplatzer双面伞闭合术后1周内,20%右心室肥厚心电图改变消退,成人中小ASD的T波改变恢复正常,术后心律失常发生率低(2.6%),且在1周内恢复。结论:①ASD心电图主要表现为右室舒张期负荷增重,V_1(V_3R)多呈右束支阻滞图型;②Amplatzer双面伞闭合ASD后1周起右心负荷逐渐消退。
To summarize the changes of electrocardiogram (ECG) within 1 week after ASD electrocardiogram and Amplatzer double-sided umbrella closure, 152 cases of pure ASD with normal lung total resistance and Qp / Qs = 1.5-3.0 were observed by electrocardiogram and compared with those of ASD, Age-related. The results showed that: (1) Right deviation and right deviation of QRS axis were 52% and 47.4%, respectively, while left deviation was rare (0.6%). V_1 (V_3R) showed mostly right bundle branch block pattern (67.1%), followed by rS pattern (28.3%), Rs right ventricular hypertrophy type rare (4.6%), no qR type. TV_ (5-6) inversion accounted for 7.3%, severe arrhythmia was rare (3 cases of atrial fibrillation); ② ASD (≥25mm) right heart load significantly increased weight (P <0.005) There was no significant relationship with age, but those with CRBBB pattern were> 30 years old, and those with atrial fibrillation were> 40 years old. (3) Within one week after Amplatzer double-sided umbrella closure, 20% of right ventricular hypertrophy changed, The waves returned to normal, the incidence of postoperative arrhythmias was low (2.6%) and recovered within 1 week. Conclusion: ①ASD ECG mainly showed right ventricular diastolic load, V_1 (V_3R) showed mostly right bundle branch block pattern; ②Amplatzer double-sided umbrella closed ASD 1 week after right heart load gradually subsided.