目的 回顾性分析5例双向性室性心动过速(Bidirectional Ventricular Tachycardia
BVT)患者的心电图和临床特征,提高临床对BVT机制和典型特征的认识。方法 收集河南省人民医院2018年10月至2022年3月资料完整的BVT患者5例,分析其临床资料及心电图特征。结果 男4例,女1例;年龄27~68岁,平均48.4岁;地高辛中毒2例,免疫抑制剂相关心肌炎2例,低血钾1例;死亡3例、恢复窦律1例,转为无休止性室速1例;5例均节律匀齐,胸导联呈右束支阻滞图型2例、左右束支阻滞图型交替出现2例、左束支阻滞图型1例;肢体导联QRS波呈两种形态交替尤为明显;电轴表现为左偏右偏交替4例,左偏不偏交替1例。结论 (1)双向性室速病情凶险,地高辛中毒和低血钾是BVT常见原因,ICIs相关心肌炎需引起临床重视;(2)心电图表现为两种形态的QRS波有规律交替出现,节律整齐,胸导联呈单一束支阻滞图型或左右束支阻滞图型交替,电轴极向改变。
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