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患者女性,30岁,1983年11月健康体检时发现心律不齐,心电图报告为窦性心动过缓,频发房性早搏伴室内差异性传导。图1系Ⅱ导联连续记录的心电图。一、P波有两种形态:1.圆钝型P波,振幅0.10mV,宽0.08秒,P-R0.13秒,P-P0.88秒,频率68次/分,判断为窦性P波;2.尖峰型P′波,以早搏形式出现,配对时间不固定,振幅0.15mV,宽0.06秒,P-R0.12—0.20秒,可确认是房性异位P波;有时重叠于前一次心动的T波上,部分P′波未下传。各异位P′波之间的最大公约数为1.37±0.03秒。二、QRS波群大致可分三种形态:1.R型,振幅约0.9mV,时限0.08秒,大多在窦P后出现,个别出现在P′波之后,2.高R型,出现在房性异位P′波之后,振幅1.2—2.1mV,时限0.08秒;3.宽R型,振幅0.9mV,时限0.12秒,全部出现在与T波重叠的P′波之后。后两种皆属室内差异传导。
Female, 30 years old, found irregular heartbeat during a physical examination in November 1983, electrocardiogram reported as sinus bradycardia, frequent atrial premature beats with room-specific differential conduction. Figure 1 Department of Ⅱ lead continuous recording of the ECG. First, the P wave has two forms: 1. P wave blunt type, amplitude 0.10mV, width 0.08 seconds, P-R0.13 seconds, P-P0.88 seconds, the frequency of 68 beats / min, to determine the sinus P Wave; 2. Spike-type P ’wave appears in premature beat, the matching time is not fixed, amplitude is 0.15mV, width is 0.06s, P-R is 0.12-0.20s, it can be confirmed as atrial ectopic P wave; The previous heartbeat of the T wave, part of the P ’wave is not downloaded. The greatest common divisor between each ectopic P ’wave is 1.37 ± 0.03 seconds. Second, QRS complex can be roughly divided into three forms: 1.R type, amplitude of about 0.9mV, the time limit of 0.08 seconds, mostly appear after the sinus P, some appear in P ’wave, 2. High R type, appeared in the room After the ectopic P ’wave, the amplitude of 1.2-2.1mV, the time limit of 0.08 seconds; 3. Wide R-type, amplitude 0.9mV, time limit of 0.12 seconds, all appear in the T wave overlap P’ wave. The latter two are indoor differential conduction.