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目的探讨无人区电轴与兔耳征对心房颤动(AF)伴宽QRS波的鉴别诊断价值。方法对65例AF合并宽QRS波者,经综合判断为AF合并室性期前收缩(PVS)40例,AF合并室内差异传导(差传)25例。经体表心电图I、aVF导联目测心电轴,根据V1导联QRS波形态判断有无兔耳征。结果 65例中,11例存在无人区电轴者均发生于AF合并PVS,无一例出现于AF合并差传者。13例左兔耳征者亦均发生于AF合并PVS。两者诊断AF合并PVS的特异性均达100%。22例右兔耳征者中有15例为AF合并差传。结论无人区电轴及左兔耳征均可作为鉴别AF合并PVS或差传的指标,两者特异性均很高,具有重要的临床意义,但敏感性较低。
Objective To investigate the diagnostic value of unmanned electric axis and rabbit ear sign in differential diagnosis of atrial fibrillation (AF) with wide QRS wave. Methods Totally 65 cases of AF patients with wide QRS wave were enrolled in this study. Forty patients with AF combined with ventricular premature contractions (PVS) and 25 patients with differential ventricular conduction (DIF) were enrolled in this study. The body surface ECG I, aVF lead visual ECG axis, according to the V1 lead QRS waveform to determine whether the rabbit ear sign. Results Of the 65 cases, 11 cases with unmanned axis were found in AF with PVS, none in those with AF. 13 cases of left ear ear sign also occurred in AF with PVS. The specificity of both diagnosing AF with PVS was 100%. Fifteen of the 22 right rabbit ear traps were combined with AF. Conclusion The unmanned axis and the left rabbit ear sign can both be used as an index to identify the combined PVS or differential transmission of AF. Both of them are of high specificity and have important clinical significance but low sensitivity.