Bär F W, Brugada P, Dassen W R, Wellens H J
Am J Cardiol. 1984 Sep 1;54(6):555-60. doi: 10.1016/0002-9149(84)90247-9.
One hundred eighty-seven patients with clinically documented supraventricular tachycardia with a narrow QRS complex were admitted for electrophysiologic study. The diagnoses after this study were circus movement tachycardia using an accessory pathway in 50 patients, atrioventricular nodal tachycardia in 50 patients, atrial flutter in 50 patients, atrial tachycardia in 27 patients and an incessant tachycardia retrogradely using a slowly conducting accessory pathway in 10 patients. On retrospective analysis, 5 criteria on the 12-lead electrocardiogram during tachycardia were analyzed for their value in making the diagnosis of site of origin. These criteria were P-wave location, axis of the P wave, atrial rate, alternation of the QRS complex and atrioventricular relation. Fifty-seven patients with a narrow QRS tachycardia were prospectively studied using the 5 criteria. A correct diagnosis was made in 48 of the 57 patients (84%). Thus, in most patients with a narrow QRS tachycardia, information from the 12-lead electrocardiogram is adequate for diagnosis.
187例临床记录有窄QRS波群室上性心动过速的患者入院接受电生理检查。检查后诊断为：50例使用附加旁道的折返性心动过速，50例房室结性心动过速，50例心房扑动，27例房性心动过速，10例使用缓慢传导附加旁道的持续性逆向心动过速。通过回顾性分析，对心动过速时12导联心电图的5项标准在确定起源部位诊断中的价值进行了分析。这些标准包括P波位置、P波电轴、心房率、QRS波群交替和房室关系。采用这5项标准对57例窄QRS波心动过速患者进行了前瞻性研究。57例患者中有48例（84%）诊断正确。因此，在大多数窄QRS波心动过速患者中，12导联心电图的信息足以做出诊断。
