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电轴右偏(RAD)是左束支阻滞(LBBB)罕见伴发症,LBBB中不足1％。既往认为由右室肥大、左室游离壁梗塞以及LBBB伴重度左后分支阻滞所引起,但本文报道3例均为特发性充血性心肌病。例1,58岁男性,发病6个月时ECG示LBBB、电轴正常,后出现房颤,电轴右偏达+100°。例2,58岁男性,ECG示LBBB伴电轴±180°,胸导联主波一致性向下。例3,40岁女性,7年前因肺栓塞作下腔静脉结扎,ECG示LBBB伴电轴+140°,尸解示心肌非特异性纤维化伴小血管栓塞,肺动脉、股静脉和下腔静脉手术结扎缘上下未见栓子。作者回顾文献50例,并结合上述3例发现:心脏扩大
Right axial deviation (RAD) is a rare complication of left bundle branch block (LBBB), less than 1% of LBBB. Previously thought to be caused by right ventricular hypertrophy, left ventricular free wall infarction and LBBB with severe left posterior branch block caused, but this article reports 3 cases were idiopathic congestive cardiomyopathy. Example 1,58-year-old man, the incidence of 6 months when the ECG showed LBBB, normal axis, after atrial fibrillation, the electric axis right partial up to +100 °. Example 2, Male at age of 58 years, ECG showed LBBB with axis ± 180 °, and the lead of the chest lead was consistent downward. Example 3,40 years old female, 7 years ago due to pulmonary embolism for inferior vena cava ligation, ECG showed LBBB with axis + 140 °, autopsy showed myocardial non-specific fibrosis with small vessel embolism, pulmonary artery, femoral vein and inferior vena cava Surgical ligation margin up and down no emboli. The authors review the literature of 50 cases, combined with the above three found: heart enlargement