体表记录心室晚电位对冠心病室性心律失常临床意义

THE VALUE OF SIGNAL-AVERAGED ELECTRO-CARDIOGRAPHY IN IDENTIFYING PATIENTS OF VENTRICULAR ARRHYTHMIAS WITH CORONARY ARTERY DISEASE

本文应用体表记录心室晚电位的方法,对220人(正常人78名);急性心肌梗塞92例;陈旧心肌梗塞50例;心绞痛10例进行了检测。正常人无一例晚电位阳性,而陈旧心肌梗塞合并室性心动过速(室速)者晚电位阳性率高达66.7%。心肌梗塞部位、室壁瘤及左室射血分数与晚电位缺乏相关性。体表记录心室晚电位对于冠心病室性心律失常的检测不失为一种有价值的非创伤性手段。

To determine the value of signal-averaged electrocardiographic detection of late potentials (LPs)in patients with coronary disease, 78 normal subjects and 142 patients with coronary atlery disease underwent signal-averaged electro-eardiogiaphy. Duration of the filtered QRS(QRSD), the QRS amplitude of the last 40ms (V40) and the duration of QRS low-amplitude potentials (LPD) were analysed to define the late potentials. No LPs was found in normal subjects, in patients with coronary artery disease, LPs were associated with ventricular tachycardia, but are not associated with aneurysm, location of myocardial infarction and left ventricular function. We concluded that signal-averaged electrocardio-graphy is a valuable noninvasive method for the detection of ventricular tachycardia in patients with coronary artery disease.