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患者男性,58岁,反复头昏6年、阵发性夜间呼吸困难反复发作1个月入院。临床诊断:原发性二尖瓣脱垂症,慢性房颤,充血性心力衰竭三级。平卧位心电监护模拟 V_5导联描记(图1A)示房颤,心室率70次/min 左右,QRS 波群呈qR 型及 rS 型两种间歇出现,与频率无关,也无体位改变。同日描记心电图(图1B)),仍为房颤心律,室率70次/min,电轴+98°,Ⅰ、aVL 呈 rS型,Ⅱ、Ⅲ、aVF 呈 qR 型,V_1—V_4呈 rS 型,Sv_2=32mm,Rv_6=20mm,V_6ST 段缺血型压低0.
Male patient, 58 years old, dizziness, repeated 6 years, paroxysmal nocturnal dyspnea recurrent onset of 1 month admission. Clinical diagnosis: primary mitral valve prolapse, chronic atrial fibrillation, congestive heart failure three. In the supine position, ECG V5 lead tracing (Fig. 1A) showed atrial fibrillation with a ventricular rate of about 70 beats / min. The QRS complex appeared as an intermittent pattern of qR and rS, independent of frequency and without change of body position. On the same day, electrocardiogram (Fig. 1B)) was still atrial fibrillation with ventricular rate of 70 beats / min, electrical axis + 98 °, Ⅰ, aVL rS, Ⅱ, Ⅲ aVF qR, V_1-V_4 rS , Sv_2 = 32mm, Rv_6 = 20mm, V_6ST segment ischemic pressure down 0.