特发性室速射频消融术后电张调整性T波变化的临床观察

目的探讨特发性室速射频消融术后3d内电张调整性T波（EMTV）产生的相关性、变化规律及其临床意义。方法对87例特发性室速患者（左室特发性室速47例,右室特发性室速40例）行射频消融术（RFCA）治疗,观察心室除极顺序及术后3d内心电图EMTV产生的相关性。结果（1）EMTV的产生与心室异常除极顺序有关,右室流出道室速RFCA后不出现EMTV;（2）左室特发性室速比右室特发性室速更易产生EMTV（P〈0.01）;（3）EMTV的产生与术中消融的即时有效时间呈负相关,与其他的诱发条件无显著相关性;（4）不同部位的心室最早异常除极产生EMTV的导联分布特征及其深度、宽度不同。结论特发性室速射频消融术后可出现EMTV,EMTV是一种心肌电生理特性,根据其特性可与缺血性心脏病、心肌病等器质性心脏病引起的T波改变相鉴别。

Clinical observation of electrotonic modulation of the T wave after radiofrequency current catheter ablation in idiopathicventricular tachycardia

Objective To investigate the regularity and clinical significance of electrotonic modulation of the T wave（EMTV）within 3 days after radiofrequency current catheter ablation（RFCA）in idiopathicventricular tachycardia.Methods The sequence of ventricle depolarization and the emerge of EMTV within 3 days after RFCA were observed in 87 patients with idiopathicventricular tachycardia（47 left idiopathic ventricular tachycardia,40 right idiopathic ventricular tachycardia）.Results（1）There was no EMTV in the right outflow tract after RFCA;（2）The incidence rate of EMTV in left ventricular tachycardia was more higher than that in right ventricular tachycardia after RFCA（P〈0.01）;（3）The EMTV and the immediate effective time in RFCA was negatively correlated;（4）The characters of distribution of the lead and the depth 、width of EMTV after RFCA was different.Conclusion EMTV can occur after RFCA in paroxysmal tachycardia patients,which is a normal electrophysiological manifestation of heart muscle after an abnormal depolarization.