经食管心房起搏对功能性左束支阻滞的研究

研究V1导联左束支阻滞QRS波形的早期表现 ,以及左束支阻滞从不完全性到完全性在V1导联QRS波形的演变规律和影响功能性左束支阻滞显现的因素。 10 0例经食管心房程序刺激显现的具有直接显示性左束支文氏阻滞特征的功能性左束支阻滞病人与 10 0例无功能性束支阻滞的正常者作对比研究。结果 :①功能性左束支阻滞的检出率为 6 .73% ;②V1导联左束支阻滞的早期QRS波形的表现为SV1增深。左束支阻滞从不完全性到完全性在V1导联QRS波形的演变规律为正常rS—深S波的rS—窄QS—宽QS ;③功能性左束支阻滞的房室交界区功能不应期略短于左束支有效不应期 ,而房室交界区相对不应期、功能不应期则显著短于对照组 (5 4 2± 95msvs 5 74±6 4 .1ms,4 15± 5 1.4msvs 4 4 1± 5 1.7ms ,P <0 .0 1)。结论 :左束支阻滞从不完全性到完全性在V1导联上可呈现其演变规律。

Study of Functional Left Bundle Branch Block by Transesophague Atrial Pacing

The early signs of left bundle branch block (LBBB) and during the development regularity of LBBB from incomplete to complete in lead V_1 and factors of affecting functional LBBB were studied. We analysed the relation between the 100 patients with functional LBBB of direct display Wenckebach LBBB characteristic and 100 patients with non-functional LBBB by transesophague atrial pacing. Results:①The detectable rate of functional LBBB was 6.73%.②The early signs of LBBB were S_ V1 increases.During the development regularity of LBBB from incomplete to complete were normal r S—deep S wave of rS—narrow QS-wide QS in lead V_1. ③The functional refractory period(FRP) of atrioventricular junctional area was slightly less than the effective refractory period(ERP) of left bundle branch in functional LBBB group. Both the relative refractory period(RRP) and FRP of atrioventricular junctional area in functional LBBB group were significantly less than that of control group(542±95 ms vs 574±64.1 ms,415±51.4 ms vs 441±51.7 ms,P <0.01).Conclusion:There are development regularity of LBBB from incomplete to complete in lead V_1.