微伏T波电交替监测对恶性心律失常的预测价值

Predictive value of microvolt T-wave alternans for malignant arrhythmia

目的目的观察微伏T波电交替(TWA)监测对缺血性心脏病伴室性心律失常患者发生恶性心律失常的预测价值。方法 80例缺血性心脏病伴室性心律失常患者随机分为观察组和对照组各40例,根据患者临床症状和实验室检查预测恶性心律失常的发生,观察组同时用TWA监测预测恶性心律失常的发生。观察两组预测准确率、从发生心脏猝死到抢救用时、抢救成功率及抢救后并发症发生情况。结果观察组发生恶性心律失常18例,其中预测准确14例,发生而未预测2例,未发生却被预测2例,预测准确率为77.8%(14/18);对照组分别为26、15、6、5例和77.8%(15/26),两组预测准确率比较,P<0.05。结论 TWA监测可有效预测缺血性心脏病伴室性心律失常患者恶性心律失常的发生。

Objective To observe the predictive value of microvolt T-wave alternans （ TWA） monitoring for malignant ventricular arrhythmia in patients with ischemic heart disease and ventricular arrhythmia .Methods Eighty cases of ische-mic heart disease with ventricular arrhythmia were randomly divided into the observation group and control group with 40 ca-ses in each group .According to clinical symptoms and laboratory tests in patients , we predicted the occurrence of malignant ventricular arrhythmias , and in the observation group , we predicted malignant arrhythmia by TWA monitoring .The predic-tion accuracy , rescue success rate and complications from the occurrence of sudden cardiac death to being rescued were ob -served.Results In the observation group , 18 cases had malignant arrhythmia , the accurate prediction was found in 14 ca-ses, 2 cases had not predicted , and 2 cases did not occur but had been predicted , the predictive accuracy rate was 77.8%（14/18）;the control group were 26, 15, 6, 5 and 77.8%（15/26）, （P＆lt;0.05）.Conclusion TWA monitoring can ef-fectively predict the occurrence of malignant arrhythmia in patients with ischemic heart disease and ventricular arrhythmia .