对比
完全性右束支传导阻滞 vs 完全性左束支传导阻滞: 临床与心电图鉴别
基于MioAtlas 3D心脏模拟器模型的完全性右束支传导阻滞与完全性左束支传导阻滞横向对比。
按解剖生理分层与诊断参数列出的表现
| 层面 / 表现 | 完全性右束支传导阻滞 | 完全性左束支传导阻滞 |
|---|---|---|
| 临床概要 |
右心室无法通过右束支接收激动冲动，激动经心室间隔由左心室心肌细胞缓慢传导至右心室导致延迟激动。QRS时限 ≥ 120 ms，V1-V2导联呈典型的rSR'（“兔耳征”）波型，I、aVL和V6导联呈宽大粗钝的S波。右胸导联伴继发性复极改变。 |
左束支主干完全阻滞。心室激动发生剧烈改变：室间隔从右向左除极，左心室激动显著延迟且缓慢。QRS波群增宽（≥ 120 ms），I、aVL、V5-V6导联呈宽大粗钝或有切迹的R波，V1-V2导联呈深宽QS或rS波。侧壁导联正常的室间隔q波消失。 |
| 心率 |
75 bpm (min: 60, max: 100) |
75 bpm (min: 60, max: 100) |
| QRS时限 |
135 ms |
150 ms |
| 发生机制 |
bloqueo |
bloqueo |
| AV传导 |
1:1 |
1:1 |
| 关键导联 |
V1, V2, I, aVL, V6 |
V1, V2, V3, I, aVL, V5, V6 |
文献来源与参考文献
完全性右束支传导阻滞
- Surawicz B, Childers R, Deal BJ, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: Part III: Intraventricular conduction disturbances . Circulation (2009) . DOI: 10.1161/CIRCULATIONAHA.108.191095
- Anderson RH, Yanni J, Boyett MR, Chandler NJ, Dobrzynski H. The anatomy of the cardiac conduction system . Clin Anat (2009) . DOI: 10.1002/ca.20700
- Kligfield P, Gettes LS, Bailey JJ, et al. Recommendations for the standardization and interpretation of the electrocardiogram: Part I: The electrocardiogram and its technology . Circulation (2007) . DOI: 10.1161/CIRCULATIONAHA.106.180200
完全性左束支传导阻滞
- Surawicz B, Childers R, Deal BJ, et al. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: Part III: Intraventricular conduction disturbances . Circulation (2009) . DOI: 10.1161/CIRCULATIONAHA.108.191095
- Anderson RH, Yanni J, Boyett MR, Chandler NJ, Dobrzynski H. The anatomy of the cardiac conduction system . Clin Anat (2009) . DOI: 10.1002/ca.20700
- Kligfield P, Gettes LS, Bailey JJ, et al. Recommendations for the standardization and interpretation of the electrocardiogram: Part I: The electrocardiogram and its technology . Circulation (2007) . DOI: 10.1161/CIRCULATIONAHA.106.180200