显性预激射频消融术后T波记忆现象的临床意义

Clinical significance of T wave memory phenomenon in patients with manifest pre-excitation syndrome after radiofrequency current ablation

目的探讨显性预激综合征患者射频消融术后出现T波记忆现象的临床特征及意义。方法选择持续性显性预激综合征经射频消融手术后出现T波倒置的64例患者,通过观察心电图T波变化的深度来分析总结T波记忆现象的特征和发生规律。结果右后壁、右后间隔及右侧壁、右后侧壁显性旁道消融术后,T波记忆现象多出现在Ⅲ、aVF、Ⅱ导联,且T波在三导联中倒置深度差异有统计学意义(P<0.05～0.01);左后壁、左后侧壁及左后间隔显性旁道消融术后,T波记忆现象也多出现在Ⅲ、aVF导联,T波倒置深度差异无统计学意义(P>0.05)。前壁或前侧壁旁道消融后T波记忆多出现在aVL、Ⅰ导联,两导联中T波倒置深度差异有统计学意义(P<0.05)。T波记忆的出现具有规律性,在1～30d内能自行恢复。结论 T波记忆是显性预激综合征患者射频消融术后常见的一种心电现象,不具病理意义。

Objective To discuss the clinical characteristics and significance of T wave memory phenomenon in the patients with manifest pre-excitation syndrome after radiofrequency current ablation（RFCA）.Methods The patients（n=64） having T wave inversion after RFCA were chosen.The characteristics and occurrence rule were analyzed and summed up through observing the change depth of T wave in ECG.Results After RFCA of manifest accessory pathway（AP） in right posterior wall,right posterior septum or right lateral wall and right lateral-posterior wall,T wave memory phenomenon was observed in the leads of III,aVF and II,and the difference of T wave inversion depth was statistically significant（P0.05~0.01）.After RFCA of AP in left posterior wall,left lateral-posterior wall and left posterior septum,T wave memory phenomenon was observed in the leads of III and aVF,and the difference of T wave inversion depth was not statistically significant（P0.05）.After RFCA of AP in anterior wall and lateral-anterior wall,T wave memory phenomenon was observed in the leads of aVL and I,and the difference of T wave inversion depth was statistically significant（P0.05）.The occurrence of T wave memory phenomenon had regularity and would recover spontaneously within 1 day to 30 days.Conclusion T wave memory phenomenon is common in ECG without pathological significance in the patients with manifest pre-excitation syndrome after RFCA.