陈旧性心梗患者经QRS波时限预测室性心律失常

目的 通过分析陈旧性心肌梗死（OMI）患者病理性Q波、碎裂QRS波（fQRS）及其与室性心律失常的发生情况,探讨病理性Q波及fQRS与室性心律失常的关系.方法 对335例确诊陈旧性心肌梗死的患者进行动态心电图检查,将OMI伴fQRS波患者按照fQRS波时限分为fQRS≥110ms组（36例）、fQRS ＜110ms（156例）,并对两组间室性心律失常发生率进行对比分析;将OMI伴病理性Q波患者按照病理性Q波QRS波群时限分为QRS≥110ms组（21例）、QRS ＜110ms（75例）,并对两组间室性心律失常发生率进行对比分析.结果 OMI伴fQRS波患者fQRS≥110ms组室性心动过速发生率明显高于fQRS＜110ms （p=0.026）;OMI伴病理性Q波患者QRS≥110ms组成对室性期前收缩（p=0.045）及室性逸搏心律（p=0.026）发生率明显高于QRS＜110ms组.结论 OMI伴fQRS患者随着fQRS时限延长,发生室性心动过速的风险随之增高;OMI伴病理性Q波患者随着QRS波时限延长,发生成对室性期前收缩及室性逸搏心律的风险随之增高.

The study on the relationship between QRS duration and ventricular arrhythmias in old myocardial infarction (OMI) patients

Objective By analyzing the incidence of QRS fragmentation wave （fQRS）,pathological Q waves and ventricular arrhythmias in patients with old myocardial infarction （OMI）,to explore the relationship between fQRS and pathological Q waves with ventricular arrhythmias.Methods The Hoher was obtained from all 335 patients with definite ventricular arrhythmias.According to fQRS wave duration,OMI patients with fQRS were divided into fQRS ≥ 110ms group （36）,fQRS ＜110ms group （156）,and the incidence of ventricular arrhythmias between the two groups were analyzed.According to QRS wave duration of pathologic Q waves,OMI patients with pathologic Q wave were divided into QRS ≥ 110ms group （21）,QRS ＜110ms group （75）,and the incidence of ventricular arrhythmias between the two groups were analyzed.Results The incidence of ventricular tachycardia in QRS ≥ 110ms group of OMI patients with fQRS is significantly higher than QRS ＜ 110ms group of OMI patients with fQRS （p=0.026）; The incidence of paired ventricular premature contractions （p=0.045） and ventricular escape rhythm （p=0.026） in QRS ≥ 110ms group of OMI patients with pathologic Q wave is significantly higher than QRS ＜ 110ms group of OMI patients with pathologic Q wave.Conclusions The longer fQRS duration of OMI patients with fQRS,the higher the risk of ventricular tachycardia; and the longer QRS duration of OMI with pathological Q wave,the higher the risk of paired ventricular premature contractions and ventricular escape rhythm.