用QT间期离散度监测充血性心力衰竭患者使用抗心律失常药物致心律失常的研究

ObjectiveTo investigate changes in QT dispersion in proarrhythmia during use of antiarrhy thmicdrug in patients with congestive heart failure (CHF).MethodsQTdispersion,left ventricular ejection fraction(LVEF) and ambulatory ECG were d etermined in188 patients with CHF,a nd they were divided into simple CHF group and CHF accompaniedwith arrhythmia g roup.In addition,102 healthy volunteers served as normal controls.Valuesof QT i nterval dispersion(QTcd) were compared in various groups in relation to heartfunction and before and af ter the use of antiarrhythmic drugs.ResultsThevalue of QTcd in CHF accompanied with arrhythmia group was higher than simpl e CHF group〔（86.16±24.33）ms vs.(69.76±19.51）ms,P< 0.01〕,and it was higher in CHFLVEF<0.40 group than LVEF>0.40 group 〔（90 .21±28.43）ms vs.(73.45±20.26）ms,P<0.01〕.Thevalue of QTcd was correlated negatively with LVEF (r=－0.427，P<0.01 ）.The valuesof QTcd in patients developed proarrhythmia 〔（99.82±30. 44）ms〕 were much higherthan those prior to antiarrhythmic drug treatment 〔 （86.16±24.23）ms,P<0.05〕 orthose with improvement during treatment 〔（58.11±18.22）ms,P<0.05〕.However,therewas no significant difference in the value of QTcd between patients who developed proarrhythmia and those with fatal outcome (P>0.05).In addition,the number o f patients withproarrhythmia in CHF LVEF<0.40 group was significantly la rger than CHF LVEF>0.40group (16/92 vs.4/96.P<0.001).ConclusionsIn patients withCHF,proarrhythmia commonly occurred when antiarrhythmic drug is used,together withincrease in QTcd value.The changes in QT dispersion is an im portant index in monitoringcurative effect of antiarrhythmic drug and proarrhyt hmia.

Proarrhythmia of antiarrhythmic drug assessed by QT dispe rsion in patients with congestive heart failure