aVR导联的临床应用——被忽视的心电图导联
Clinical utility of aVR-The neglected electrocardiographic lead.
作者信息
Kireyev Dmitriy, Arkhipov Mikhail V, Zador Stephen T, Paris Joseph A, Boden William E
机构信息
State University of New York at Buffalo, USA.
出版信息
Ann Noninvasive Electrocardiol. 2010 Apr;15(2):175-80. doi: 10.1111/j.1542-474X.2010.00359.x.
BACKGROUND
Several studies suggest that electrocardiographers tend to neglect lead aVR during the reading of electrocardiograms (ECGs). Our objective was to provide a systematic review of the most important diagnostic and prognostic uses of lead aVR.
METHODS
We performed a thorough review of the literature about the lead aVR using PubMed, MEDLINE and the archives of the University at Buffalo libraries.
RESULTS
We found that lead aVR may provide important additional information in the diagnosis of coronary artery disease. It may provide a clue to the location of a lesion as well as the possibility of three vessel disease during an acute coronary syndrome. Lead aVR was found useful in the locus of arrhythmias and in differentiation of narrow and wide QRS complex tachycardias. It provides useful prognostic information for patients with the Brugada syndrome and tricyclic antidepressant toxicity. Lead aVR provides alternative criteria for the electrocardiographic diagnosis of left ventricular hypertrophy and left anterior fascicular block.
CONCLUSION
Lead aVR provides very important additional diagnostic and prognostic information in multiple cardiac conditions and can be used either alone or in conjunction with other electrocardiographic leads.
背景
多项研究表明，心电图解读过程中，心电图技师往往会忽略aVR导联。我们的目的是对aVR导联最重要的诊断和预后用途进行系统综述。
方法
我们使用PubMed、MEDLINE以及布法罗大学图书馆的存档对有关aVR导联的文献进行了全面回顾。
结果
我们发现，aVR导联在冠状动脉疾病的诊断中可能提供重要的额外信息。它可能为病变位置以及急性冠状动脉综合征期间三支血管病变的可能性提供线索。aVR导联在心律失常的定位以及窄QRS波群和宽QRS波群心动过速的鉴别中很有用。它为Brugada综合征和三环类抗抑郁药中毒患者提供有用的预后信息。aVR导联为左心室肥厚和左前分支阻滞的心电图诊断提供了替代标准。
结论
aVR导联在多种心脏疾病中提供非常重要的额外诊断和预后信息，可单独使用或与其他心电图导联联合使用。
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