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目的通过对右室流出道(RVOT)室间隔起搏心电图(ECG)分析,探讨QRS波群主波方向与右室流出道(RVOT)室间隔起搏定位的关系。方法永久性心脏起搏器植入患者92例,全部使用主动螺旋电极行RVOT室间隔起搏。术中在X线透视后前位(AP)及左前斜位(LAO)40°下确定导线的位置,术后记录患者的ECG(起搏状态下),观察12标准导联的QRS波群主波方向,尤其是I导联、avF导联QRS波群主波方向,并分别统计它们的百分比。结果92例RVOT室间隔起搏患者中,I导联QRS波方向正向有83例(90％),负向仅为6例。26例高位RVOT室间隔起搏患者中,avF导联QRS波方向正向有25例(96％),仅1例负向:66例低位RVOT室间隔起搏患者中,avF导联QRS波方向正向有52例,7例QRS波方向负向,7例QRS波方向正负双向．结论RVOT室间隔起搏I导联、avF导联QRS波群主波方向均以向上为主,有助于RVOT室间隔起搏定位。
Objective To investigate the relationship between the main wave direction of QRS complex and ventricular septal pacing in right ventricular outflow tract (RVOT) through electrocardiogram (ECG) analysis of RVOT. Methods Permanent pacemakers were implanted in 92 patients, all using active spiral electrode RVOT ventricular septal pacing. Intraoperative radiography in the anterior (AP) and left anterior oblique (LAO) 40 ° to determine the location of the wire, postoperative patients recorded ECG (pacing state), observed 12 standard lead QRS wave group Wave direction, especially the I lead, avF lead QRS wave group the main wave direction, and statistics, respectively, their percentage. Results Among 92 patients with ventricular tachycardia, 83 cases (90%) were positive in QRS wave and 6 cases were negative. Of the 26 patients with RVOT, there were 25 (96%) positive QRS waves in the avF lead, and only 1 negative: in the 66 patients with RVOT ventricular pacing, the QRS wave direction of the avF lead Positive in 52 cases, 7 cases of QRS wave direction negative, 7 cases of QRS wave direction positive and negative two-way. Conclusion RVOT ventricular septal pacing lead, avF lead QRS wave group in the main wave direction are upward mainly to help RVOT ventricular septal pacing positioning.