Figure 1 ECG analysis:
P waves appear regularly, upright in I, II, III, aVF and chest leads, avR is inverted, PR interval is about 0.18s, atrial rate is about 54bpm, so the basic heart rhythm is sinus cardiopathy slow.
R3-R6 is paroxysmal atrial tachycardia starting from atrial premature, with an atrioventricular conduction ratio of 1:1.
R1-R3 and R7-R12 showed incomplete right bundle branch block, and R4-R6 showed complete right bundle branch block, suggesting that fast ventricular rate can induce the aggravation of right bundle branch block.
Figure 2 ECG analysis :
The basic heart rhythm is sinus rhythm .
R3, R5, R7, R10, and R12 appear early and are supraventricular, preceded by P' (sometimes overlapping with T, obvious in lead V1.), P'R0.12s, accompanied by incomplete compensatory pauses. So it is premature atrial contraction. R5, R10, R12 are obviously different from sinus QRS, which is premature atrial contractions with complete right bundle branch block.
Figure 3 ECG analysis :
The basic heart rhythm is sinus bradycardia and is uneven.
R2 and R7 appear early, with wide deformity. There is no related P wave in the front, and there is sinus P wave in the back (all marked in red are sinus P). is premature ventricular contraction . R2 is accompanied by a completely compensated interval, and R7 is without a compensated interval, which is insertional ventricular premature, followed by interfering PR interval delay, and induces R8 to show complete right bundle branch block type .
Figure 4 ECG analysis :
The basic heart rhythm is sinus rhythm.
R4 appears early and is wide and deformed. There is no related P wave in the front and sinus P wave in the back (the ones marked in red are sinus P). is premature ventricular contraction .
R8 appears early, and its shape is obviously different from that of sinus QRS. It is preceded by P' (blue mark), P'R0.12s, and accompanied by incomplete compensatory intervals, so it is premature atrial contraction with complete right bundle branch obstruction. lag .
Figure 5 ECG analysis :
The basic heart rhythm is sinus bradycardia and uneven.
R5 and R13 are insertional premature ventricular contractions .
R15 is premature atrial contractions with complete right bundle branch block .
Figure 6 ECG analysis :
The basic heart rhythm is sinus bradycardia.
R2 and R9 are insertional premature ventricular contractions, and induces R3 and R10 to be complete right bundle branch block type . R13 is premature ventricular contraction , with complete compensatory pauses.
R15, R17, R20, R22, and R25 are premature atrial contractions with complete right bundle branch block .
scatter plot expresses the regularity of adjacent RR intervals with the position of points. Drawing principle: Taking the adjacent RR periods as the horizontal (x-axis) and vertical (y-axis) coordinates, depict the RR interval scatter set (Rn-Rn-1) of the dynamic electrocardiogram in the plane rectangular coordinate system ,Rn+1-Rn). Since a Lorenz scatter point expresses the regularity of two adjacent RR intervals, involving three adjacent heart beats Rn-1, Rn, and Rn+1, the Lorenz scatter point is a three-beat and two-phase point.
red is chamber early point set, purple is atrial point set, blue is sinus point set.
Related knowledge points:
1. Premature ventricular contractions
originate from unprotected premature contractions below the bifurcation of the His bundle, called premature ventricular contractions , also known as premature ventricular contractions.
In addition to premature ventricular septal contractions, the ventricular QRS-T waveform is wide and deformed, and there are no relevant atrial waves before the QRS (except for ventricular fusion waves).
General characteristics:
1, a wide and deformed QRS complex appears in advance with a time of ≥0.12s, and the T wave is opposite to the main wave direction.
2, there is no relevant P wave before it, and there are occasional P waves after it.
3, most of them are accompanied by complete compensatory intermittent , and a few are insertive.
2. Insertive ventricular premature ejaculation PR Interval prolongation
Insertive ventricular premature usually causes subsequent first or several consecutive sinus PR intervals to be prolonged and the R wave to move backward. At this time, the sum of the measured premature ventricular coupling interval plus the compensatory interval is greater than one The basic heart rhythm cycle is obviously shorter than two basic heart rhythm cycles, which is a sub-compensatory interval.
There are two explanations for the mechanism of PR interval prolongation caused by premature ventricular excitement: ① The premature ventricular impulse is retrogradely transmitted to the atrioventricular node , causing it to generate a new refractory period . When the next sinus impulse reaches the atrioventricular node area, It coincides with the relative refractory period of premature ventricular period, and interfering PR interval prolongation occurs. ② Premature ventricular activation is blocked by the fast pathway of the atrioventricular node, and the next sinus activation is transmitted down to the ventricle by the slow pathway of the atrioventricular node, resulting in a sudden prolongation of the PR interval.
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