房室旁路射频消融术后心电图T波形态及血清肌钙蛋白I的变化观察

The clinical assessment of T-wave changes and cardiac troponin Ⅰ after radiofrequency ablation of accessory atrioventricular pathway

目的观察房室折返性心动过速射频消融术(RFCA)后的心电图T波形态及血清肌钙蛋白Ⅰ(cTnI)的变化,探讨其T波变化的临床意义。方法选择42例房室旁路RFCA者,分别于术前1天、术后即刻记录并对比患者心电图,测量QRS波时限及T波形态的变化。检测术前和术后24h内的cTnI。记录术中消融参数。结果42例中有19例(45.24%)术后出现T波改变,以右侧旁道多见,隐匿旁道无T波改变。T波的变化量与QRS波的变化量呈正相关(r=0.71,P<0.05)。术后cTnI较术前升高,但未显示统计学差异(P>0.05)。术后心电图有T波改变者与无T波改变者两组病例间cTnI及消融参数均无显著性差异(P>0.05)。结论RFCA术后心电图T波形态改变与心肌损伤无关,是生理性电张性调整的结果。

Objective To observe the changes of T-wave and cardiac troponin I （cTnI） after radiofrequency ablation of accessory atrioventricular pathway and evaluate the clinical signification of T - wave changes, Methods 42 patients with atrioventricular reentant tachycardia （AVRT） were selected, ECG were recorded before and after radiofrequency catheter ablation （RFCA）. QRS wave and T-wave were studied. The cTnI was tested whitin 24 hours before and after RFCA. Results T-wave changed in 19 patients after RFCA mostly in those of right-sided manifest accessory pathway, but none of the patients with a concealed pathway. There was a positive relativity in T-wave and QRS wave change. Though the amounts of cTnI elevated after RFCA, there was no significance （ P 〉 0.05）. Conclusion The T wave change after RFCA was not the result of myocardial injury during operation, maybe the electrotonic modulation after RFCA.