上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 病例报告 • 上一篇    

致心律失常性右心室发育不良的心电图演变一例报道

孟 晨，陆 悠，唐蓉蓉，何 奔   

  1. 上海交通大学 医学院附属仁济医院心血管内科， 上海 200001
  • 出版日期:2014-07-28 发布日期:2014-08-11
  • 作者简介:孟晨（1978—）， 女， 技师， 学士; 电子信箱: morningofdream@sina.com。

Electrocardiographic manifestations of arrhythmic right ventricular dysplasia: one case report

MENG Chen, LU You, TANG Rong-rong, HE Ben   

  1. Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
  • Online:2014-07-28 Published:2014-08-11

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摘要：

目的 探讨致心律失常性右心室发育不良（ARVD）的心电图演变过程。方法 对1例ARVD患者2002年与2011年的心电图表现进行对照比较，结合心脏彩色超声检查，分析病程进展对心电图表现的影响。结果 随着右心室内径增大和肺动脉压增加，QRS时限逐渐增宽；各导联QRS终末变为粗钝并伴有切迹，V1导联出现明显ε波；右胸、中胸导联T波负向程度显著加重，下壁导联T波由正向变为负向。患者始终伴有多源性室性心动过速。结论 QRS时限在ARVD早期未必延长，而随着病程的发展有逐渐增宽的趋势，且下壁导联的T波也可能受到累及。ARVD可伴有多源性室性心动过速。

关键词: 致心律失常性右心室发育不良, 多源性室性心动过速, 心电图演变

Abstract:

Objective To explore the changes of electrocardiogram (ECG) of the arrhythmic right ventricular dysplasia (ARVD). Methods The effects of the development of ARVD on ECG were analyzed by comparing ECGs of 2002 and 2011 with color ultrasonography of a patient with ARVD. Results With the increase of internal diameter of right ventricle and pulmonary arterial pressure, the QRS interval prolonged gradually; the end of QRS became slurring and notching; V1 lead showed ε wave; the degree of T wave inversion became serious from V1 to V4 leads; and the T waves of Ⅱ, Ⅲ and aVF leads also inversed. The patient showed multifocal ventricular tachycardia. Conclusion The QRS interval may not prolong at the early stage of ARVD, but with the development of the disease, it will prolong gradually and T waves of Ⅱ, Ⅲ and aVF leads may inverse. The multifocal ventricular tachycardia may accompany ARVD.

Key words: arrhythmic right ventricular dysplasia, multifocal ventricular tachycardia, electrocardiographic manifestations