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患者女性,71岁,临床诊断:高血压性心脏病。心电图(附图,见第35页)示基本心律为窦性,频率约88次/分,QRS波呈完全性左束支阻滞型,电轴约为-25°—30°。除窦性节律外,有提前出现的QRS波,配对间期明显不等,早搏的长间距是短间距的简单整倍数,常有室性融合波出现(Ⅰ的R_7、aVL的R_7、V_1的R_5和V_6的R_7)。早搏QRS时限约0.10—0.11秒,畸形较轻,趋向“正常化”,在肢导联上表现为左后分支阻滞型,在胸导联上表现为不完全性右束支阻滞型。室性融合波的QRS更加趋向“正常化”。综上分析、本图诊断为:1.窦性心律,完全性左束支传导阻滞;2.并行心律性室性早搏。
Patient female, 71 years old, clinical diagnosis: hypertensive heart disease. ECG (with photos, see page 35) showed the basic rhythm of sinus, frequency of about 88 beats / min, QRS wave was complete left bundle branch block type, the electrical axis is about -25 ° -30 °. In addition to sinus rhythm, there are premature QRS wave, the inter-matching interval was significantly different, long-distance premature beats are simple multiples of short-pitch, often with the occurrence of ventricular fusion wave (Ⅰ R_7, aVL R_7, V_1 R_5 and V_6 R_7). Early QRS duration of about 0.10-0.11 seconds, less deformity, tend to “normalize” in the limb leads on the performance of the left posterior branch block type in the chest lead showed incomplete right bundle branch block type. The QRS of ventricular fusion wave tends to “normalize” more. In summary, the diagnosis of this map: 1. Sinus rhythm, complete left bundle branch block; 2. Parallel ventricular premature ventricular contractions.