摘要
目的探讨不同原因电张调整性T波改变的心电学特征。方法对30例右心室心尖部临时或永久性起搏后、10例左室下后间隔特发性室性心动过速后及8例后间隔间歇性或持续性预激综合征射频消融术后电张调整性T波的分布特征进行分析。结果①电张调整性T波的导联分布特点为:右心室心尖部起搏组分布最广,除下壁导联(Ⅱ、Ⅲ、aVF)外,胸导联(Vl￣V4100.0%,Vl￣V676.7%)亦广泛存在,其最大倒置T波的深度(0.85±0.26mV)较特发性室性心动过速组(0.42±0.18mV)、预激综合征组(0.40±0.19mV)均深,差异有非常显著性意义(P均<0.01),最深倒置的常分布在V3、V4导联。②特发性室性心动过速组分布也较广,除下壁导联外,左胸导联(V4￣V6为100.0%)亦存在,其最深倒置的常分布在V4、V5导联。③预激综合征组分布较窄,常局限于下壁导联。结论不同原因电张调整性T波的导联分布也不同,了解这些特征有助于与心肌缺血、急性肺栓塞等所致的T波改变相鉴别。
Objective To investigate distributing characteristics of electrotonically modulated T wave with different etiology in electrocardiogram. Methods Distributing characteristics of electrotonically modulated T wave were analyzed in 30 cases with right ventricular apical temporary or permanence cardiac pacing, 10 cases with idiopathic ventricular tachycardia terminated and 8 cases who had received radiofrequency catheter ablation for Wolff-Parkinson-White syndrome(W-P-W). Results ①In patients with right ventricular apical pacing, electrotonic modulation of T waves appeared in inferior wall lead (II,III and aVF) and most of precordial leads (Vl～V4 100.0%,Vl～V6 76.7%) with deepest negative T wave in leads V3～V4 which was more significant than that in patients with idiopathic ventricular tachycardia and W-P-W syndrome (P<0.01). ②In patients with idiopathic ventricular tachycardia, electrotonic modulation of T wave appeared in inferior wall leads and left precordial leads(V4～V6) with deepest negative T waves in V4,V5. ③In patients with W-P-W, electrotonic modulation of T wave was usually limited in inferior wall leads. Conclusion Distributions of electrotonic modulation of T wave with different etiologies were diverse and such characteristics are distinguished from T wave changes of myocardial ischemia and acute pulmonary embolism.
出处
《心电学杂志》
2005年第2期67-70,83,共5页
Journal of Electrocardiology(China)
