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结构正常心脏儿童12导联心电图下特发性室性早搏的形态学特征及起源分析

Analysis of Morphological Characteristics and Origins of Idiopathic Premature Ventricular Contractions Under a 12-Lead Electrocardiogram in Children with Structurally Normal Hearts.

作者信息

Jiang Jianbin, He Yuee, Qiu Huixian, Zhang Yuanhai, Chu Maoping, Li Yuechun, Chen Qi

机构信息

Department of Children's Heart Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University.

Department of Cardiology, The Second Hospital of Wenzhou Medical University.

出版信息

Int Heart J. 2017 Oct 21;58(5):714-719. doi: 10.1536/ihj.16-418. Epub 2017 Sep 30.

Abstract

Up to 40% of healthy children have premature ventricular complexes or contractions (PVCs) detected with 24-hour Holter monitoring. We aimed to investigate the morphological characteristics and origins of idiopathic PVCs under a 12-lead electrocardiogram in children with structurally normal hearts. All asymptomatic monomorphic PVC patients with structurally normal hearts under 18 years of age were included in this retrospective study. Characteristics of PVCs in lead V under a 12-lead electrocardiogram were classified as left bundle branch block (PVC-LBBB) or right bundle branch block (PVC-RBBB). According to limb leads, PVC-LBBB or PVC-RBBB was divided into: PVCs-LBBB type I; PVCs-LBBB type II; PVCs-RBBB type I; PVCs-RBBB type II; and PVCs-RBBB type III. Out of 178 PVC patients, 94 cases of PVCs-LBBB (PVCs-LBBB type I = 60; PVCs-LBBB type II = 34) and 84 cases of PVCs-RBBB (PVCs-RBBB type I = 3; PVCs-RBBB type II = 55; PVCs-RBBB type III = 26) were identified. The frequency of PVCs-LBBB type I increased with age and the frequency of PVCs-RBBB type II and III decreased with age. Among the children monitor tested, from 1 years old to 18 years old, PVCs originating from the left or right ventricular outflow tract gradually increased with age, while PVCs originating from the branch sources decreased with age.

摘要

通过24小时动态心电图监测发现,高达40%的健康儿童有室性早搏或室性期前收缩(PVCs)。我们旨在研究心脏结构正常的儿童在12导联心电图下特发性PVCs的形态特征和起源。本回顾性研究纳入了所有年龄在18岁以下、心脏结构正常的无症状单形性PVC患者。12导联心电图下V导联PVCs的特征分为左束支传导阻滞(PVC-LBBB)或右束支传导阻滞(PVC-RBBB)。根据肢体导联,PVC-LBBB或PVC-RBBB分为:PVCs-LBBB I型;PVCs-LBBB II型;PVCs-RBBB I型;PVCs-RBBB II型;以及PVCs-RBBB III型。在178例PVC患者中,识别出94例PVCs-LBBB(PVCs-LBBB I型 = 60例;PVCs-LBBB II型 = 34例)和84例PVCs-RBBB(PVCs-RBBB I型 = 3例;PVCs-RBBB II型 = 55例;PVCs-RBBB III型 = 26例)。PVCs-LBBB I型的发生率随年龄增加,而PVCs-RBBB II型和III型的发生率随年龄降低。在接受监测的儿童中,从1岁到18岁,起源于左或右心室流出道的PVCs随年龄逐渐增加,而起源于分支部位的PVCs随年龄减少。

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