冠心病患者QT间期离散度与程序刺激诱发的室性心动过速相关性研究

目的 :探讨体表心电图QT间期离散度与冠心病患者程序刺激诱发的室性心动过速的关系。方法 :选择 4 0例接受心脏导管手术的患者 ,其中陈旧性心肌梗死患者 2 0例 ,阵发性室上性心动过速患者 2 0例。术前测定患者体表心电图QT间期离散度 ,术中在右心室起搏刺激以诱发持续室性心动过速 ,探讨QT间期离散度与室性心律失常之间的关系。结果 :2 0例陈旧性心肌梗死患者共有 6例诱发出持续室性心动过速 ,2 0例阵发性室上性心动过速患者中无 1例诱发出持续室性心动过速。冠心病患者体表心电图QT间期离散度较阵发性室上速患者明显增大 (85 .7± 2 4 .6msvs 34.8± 11.3ms,P <0 .0 1) ;冠心病患者中诱发出持续室性心动过速者 ,其QT间期离散度较未诱发出持续室性心动过速者亦明显增大 (98.7± 5 6 .2msvs 70 .4± 2 8.5ms,P <0 .0 5 )。取QT间期离散度≥ 110ms,对室性心律失常的预测有一定价值。结论 :体表心电图QT间期离散度与冠心病患者室性心律失常具有相关性 ,取QTd≥ 110ms对室性心律失常有一定的预测价值。

The relationship between QT dispersion of surface electrocardiagram and ventricular tachycardia in patients with coronary heart diseases

Objective To explore relation between QT dispersion of body-surface electrocardiogram and ventriculler tachycardia in patients with coronary heart diseases. Methods In 20 patients with coronary heart disease(CHD)and 20 patients with paroxysmal supraventricular tachycardia(PSVT), QT dispersron(QTd) of body-surface electrocardiagram was measured, and programmed ventricular stimulation(PVS)was performed in all patients to induce sustained ventricular tachycardia(VT).The relation between QTd and ventricular artachycardia was analyzed.Results In 6 patients with CHD and 0 patients with PSVT, sustained VT was induced, QTd in patients with CHD was significantly more than that of patients with PSVT(85.7 24.6 vs 34.8±11.3 ms, P <0.01) and QTd in patients with VT induced was significantly more than that in patients with VT not indnced in patients with CHD (98.7±56.2 ms vs 70.4±28.5 ms, P <0.05). When determinded as ≥110 ms,QTd had a relatively better predictive value for predicting ventricular arrhythmia.Conclusion Ventricular arrhythmia in patients with CHD with QTd of body-surface ECG when determinded as ≥110 ms,QTd is of considerable value in predicting ventricular arrhythmia.