背景:室上性心动过速(SVT),尽管具有各种解剖学基础和病理生理机制,经常显示类似的心电图表现。
目的:在具有持续快速SVT的狗的12导联心电图上定位和表征心房偏转(AD),并评估不同心电图变量在区分心动过速类型中的实用性。
方法:92只犬患有直行房室往复式心动过速,17伴有房扑,33例局灶性房性心动过速记录并通过电生理研究证实,还有40只窦性心动过速的狗.
方法:根据心内激活的顺序评估12导联表面心电图上的心房偏转位置。评估其特征以及AD与QRS波间隔(AD-R)和QRS波与AD间隔(R-AD)之间的关系。
结果:直行房室往复式心动过速的特征是AD-AD间期为213±30ms,AD的平均电轴(MEA)为-90(-90/-78)°,R-AD间隔为75(65-80)ms,R-AD/AD-R为0.54(0.45-0.64)。房扑的特点是AD-AD间期为199±57ms,MEA为76°(72/81),120(72-144)ms的R-AD,R-AD/AD-R为0.81(0.63-1.13)。局灶性房性心动过速的特征是AD-AD间期为270±38ms,MEA为49(-72/76)°,160(120-200)ms的R-AD,R-AD/AD-R为1.45(0.92-1.67)。窦性心动过速的特点是AD-AD间期为292±31ms,MEA为66°(52/73),215(192-222)ms的R-AD,R-AD/AD-R为2.68(2.25-3.08)。
结论:在12导联心电图上分析AD有助于区分狗中最常见的SVT。
BACKGROUND: Supraventricular tachycardias (SVTs), despite having various anatomical substrates and pathophysiological mechanisms, frequently show similar electrocardiographic presentations.
OBJECTIVE: To locate and characterize atrial deflections (ADs) on 12-lead electrocardiograms in dogs with sustained rapid SVT and assess the utility of different electrocardiographic variables in differentiating types of tachycardia.
METHODS: Ninety-two dogs with orthodromic atrioventricular reciprocating tachycardia, 17 with atrial flutter, 33 with focal atrial tachycardia recorded and confirmed by electrophysiological study, and 40 dogs with sinus tachycardia.
METHODS: Atrial deflection position on the 12-lead surface electrocardiogram was assessed according to the sequence of intracardiac activation. Its features were evaluated together with the relationship between AD and QRS complex interval (AD-R) and QRS complex and AD interval (R-AD).
RESULTS: Orthodromic atrioventricular reciprocating tachycardia was characterized by an AD-AD interval of 213 ± 30 ms, mean electrical axis (MEA) of AD of -90 (-90/-78)°, R-AD interval of 75 (65-80) ms, and R-AD/AD-R of 0.54 (0.45-0.64). Atrial flutter was characterized by an AD-AD interval of 199 ± 57 ms, MEA of 76° (72/81), R-AD of 120 (72-144) ms, and R-AD/AD-R of 0.81 (0.63-1.13). Focal atrial tachycardia was characterized by an AD-AD interval of 270 ± 38 ms, MEA of 49 (-72/76)°, R-AD of 160 (120-200) ms, and R-AD/AD-R of 1.45 (0.92-1.67). Sinus tachycardia was characterized by an AD-AD interval of 292 ± 31 ms, MEA of 66° (52/73), R-AD of 215 (192-222) ms, and R-AD/AD-R of 2.68 (2.25-3.08).
CONCLUSIONS: Analyzing AD on 12-lead electrocardiogram is helpful in differentiating the most common SVTs in dogs.