用高分辨叠加检测冠心病室性心律失常QRS起始部电位异常改变

用自组的多段式心电高分辨叠加检查系统,检测30例正常人、80例冠心病患者、40例冠心病合并频发室早患者、20例冠心病合并室速患者,并对QRS波群及S-T段逐组分析。结果是4组观察对象的QRS间期、起始部振幅、起始部峰迹均有显著性差异,P<0.01。心室碎裂电位的出现在4组中差异显著,P<0.005;冠心病合并室早、室速的血液动力学比率与QRS起始部振幅呈中度负相关,r=-0.51;冠心病合并心梗患者的常规12导联ECGQ波数与SAECG的QRS起始部振幅无关,r=0.27;14例下壁心梗中8例起始部振幅减小,而20例下壁心梗中19例起始部振幅减小,P<0.01。

ALTERATIONS IN THE INITIAL PORTION OF THE SIGNAL-AVERAGED QRS COMPLEX IN CORONARY HEART DISEASE WITH VENTRICULAR ARRHYTHMIA

The Multisegment Signal-averaging system set up by our Dept.was used in this study.Data from 30 healthy volunteers were compared with those from 80 patients with coronary heart disease(CHD),40 CHD with ventricular premature beats,and 20 CHD with ventricular tachycardia.Result:There are distinctly differents(P<0.01)in the duration of the signal-averaged QRS,the amplitude in the first 40ms of the QRS and the initial high frequency nocth among the four groups.The appearance of ventricular fractional potential among the four groups is also distinctly and significantly different(P<0.005).The amplitude in the first 40ms of the QRS in CHD with ventricular arrthymia was weakly related to PEP/LVET(r=0.51)and poorly correlated with the presence of Q waves on 12-lead ECG(r=0.22).An amplitude at 40ms of <30mV was significantly related to the presence of ventricular arrthymia in anterior MI patient(19/22,P<0.01),but not statistically significant in the inferior MI(8/14,P<0.05).The results suggested that the presence and extent of septal abnormalities may be important in the development of ventricular arrthymia.