频域法检测心室晚电位临床应用初探

A PRELIMITARY STUDY OF CLINICAL APPLICATION OF VENTRICULAR LATE POTENTIAL USING SIGNAL AVERAGING AND POWER SPECTRUM ESTIMATION TECHNIQUES

本文利用计算机信号平均技术及频谱估计方法对110人从体表检测心室晚电位。59个正常人中仅1例发现晚电位,阳性率为1.7％,心肌梗塞未并发室性心律失常患者24例中20.8％(5/24)有晚电位;心肌梗塞并发室性心律失常5例病人中80％(4/5)有晚电位。下壁梗塞者晚电位阳性率47.06％,高于其它部位梗塞者(8.33％)。室性早搏组及非持续性室速患者晚电位阳性率分别为30％(3/10)和38.46(5/13),而持续性室速患者阳性率高达100％(4/4)。研究结果表明:(1)心室晚电位与室性心律失常,特别是持续性室速有密切关系;(2)频阈法体表检测晚电位可能成为辨识心肌梗塞后有严重室性心律失常倾向病人的一种无创方法。

The detection of ventricular late potentials (LPs) from body surface by computer with signal averaging and power spectrum estimation techniques was studied and clinical application in 110 patients analysed. Fifty nine normal subjects served as control and 51 patients with heart diseases were studied. Only in one of the normal subjects (1.7%) LPs had been detected. Among 24 myocar-dial infarction (MI) patients without overt ventricular arrhythmia, only 5(20.8%) presented LPs. and 4 of 5 MI (80%) patients with ventricular arrhythmia episodes had LPs. Inferior infarction patients presented LPs (47%) more frequently than patients with other infarction locations (8.33%). LPs were found in 3 cases with ventricular premature beats (30%) and 5 non-sustained ventricular tachycardia (VT) cases (38.46%) respectively. All 4 cases with sustained VT (100%) had LPs recorded. The results show: Detection of LPs by using signal averaging and power spectrum estimation techniques is quite satisfactory. Therefore this noninvasive technique is justified to identify patients at risk for the development of sustained VT, especially for those after MI.