阵发性室上性心动过速时窄QRS波ST-T改变的临床意义

The Clinical Signicance of ST-T Changes During Narrow QRS Complex Tachycadia

分析经导管射频消融术治疗的224例阵发性室上性心动过速（PSVT）发作时体表12导联心电图ST－T改变。结果表明，140例房室折返性心动过速（AVRT）中ST段压低≥2mm且持续≥80ms或（和）T波倒置者86例（61．4％），明显高于房室结折返性心动过速（AVNRT）患者（29．76％，P＜0．005）．左侧旁道患者ST段压低多分布在V3～V5或V6导联，而左后间隔旁道和右后间隔旁道患者T被倒置和ST段压低多发生于Ⅱ、Ⅲ、aVF导联，提示PSVT时心电图ST－T改变可作为区分AVRT和AVNRT的指标，且可作初步的旁道定位价值（包括间隙性预激、隐匿性预缴）。对左后间隔旁道和右后间隔旁道的鉴别无明显差异。

The 12 lead ECG and cdrital electrophysioltalcal date during radiofrequency ablation wereanalysed in 224 petients with narrow one arplex tachycardia,ST segnent depression was greater orequal, 2mm or T wave inversive or the both occured more after in atrioventriculor reentranttachycardia(AVRT) than that in atrioventricutal nodal reentrant tachycardia(AVNRT) (61. 14 % 86/140 Vs 29. 76 % 25/84 P<0. 005). The mean magnitude of ST segtnent depredon was greater inAVRT that in AVNRT (1. 58± 1． 35mel Vs 0. 71 ± 0. 67 P<0． 001 ). The leads of ST segmentdeptession among the left ftee lateral wall accasory pathways frequently appeared in ranged V3 to V5or Ve leads, The leads of ST segment depression or T wave inversion among the peterior septaloccessary pathways frequently appeared in Ⅱ, Ⅲ,avF leads. The results suggest that ST-T changescan be used to differentiate AVRT from AVNRT. The disturbence of leads with ST- T changes isfacilitate to peition the accessory pethways.