左室特发性室速患者射频消融术后T波记忆现象的临床意义

Clinical Significance of T Wave Memory in Patients with Left Idiopathic Ventricular Tachycardia after Radiofrequeney Ablation

目的：探讨左室特发性室速患者射频消融术后出现T波记忆现象的特征及临床意义。方法：对30例左室特发性室速患者行射频消融手术,观察心室激动顺序改变后T波记忆现象的发生率、分布特点和规律,并研究T波记忆与室速之间的相关关系。结果：30例左室特发性室速患者经成功射频消融手术后,有13例出现T波记忆现象,发生率为43.3%。所累及的导联以Ⅱ、Ⅲ、AVF为主,也可见于V3-V6导联,其中Ⅲ导和AVF导联的出现频率可达100%。T波倒置深度Ⅲ〉aVF〉II（P〈0.05~0.01）。室速发作时持续的时间（分种数）与T波完全恢复正常的时间（天数）呈正相关关系（r=0.837,P〈0.001）。结论：T波记忆是左室特发性室速患者射频消融术后常见的一种心电现象,不具病理意义,熟悉其特点和变化规律,有助于作出正确的诊断和治疗。

Objective：To investigate the clinical significance of T wave memory in Patients with Left Idiopathic Ventricular Tachycardia（LIVT） after radiofrequeney ablation（RFCA）.Methods：Characteristics of T wave memory were analyzed before and after RFCA in 30 patients with LIVT.Results：① All 30 patients with LIVT,13 cases had T wave abnormalities after successful ablation,accounting for 43.3%;② T wave memory was mainly observed in inferior wall ECG leads（Ⅱ,Ⅲ and AVF） and amplitude of inverted T wave was ⅢavFⅡ（P0.05-0.01）;③There is a positive correlation between the duration of VT and T wave recovery time（r=0.837,P0.001）.Conclusion：T wave memory after ablation in LIVT patients is a common electrophysiological phenomenon,which should be distinguished from cardiac injury and myocardial ischemia.