获得性长QT间期综合征伴T波电交替致反复心室颤动一例

A Case of Repeated Ventricular Fibrillation Induced by Acquired Long QT Interval and T-wave Alternans

获得性长QT间期综合征(aLQTS)是由药物、心肌缺血、电解质紊乱等因素引起,临床上较常见,易导致危及生命的心律失常。T波电交替(TWA)是指在规整心律时,体表心电图上T波形态、极性和振幅逐搏交替变化,被认为与胞内钙离子有关,当钙离子不能有效地完成自身循环,使复极过程不协调就可能发生TWA。TWA为发生恶性室性心律失常及心原性猝死的独立预测指标。本文报道1例aLQTS伴TWA致反复心室颤动的病例,当多种心电现象合并出现时,更是临床上提示有一定猝死风险的预警心电图,及时采取相应措施将一定程度降低患者死亡风险。

Acquired Long QT Interval syndrome(aLQTS)could be induced by drugs,myocardial ischemia,electrolyte disorders and other factors,which is common in daily clinical practice and could easily lead to life-threatening arrhythmias.T-wave alternansn(TWA)refers to the change of T wave shape,polarity and amplitude on body surface electrocardiogram during regular rhythm,which is thought to be related to intracellular calcium ions hemostasis.TWA may occur when calcium ions cannot effectively complete their own circulation and make the process of repolarization uncoordinated.TWA was an independent predictor of malignant ventricular arrhythmia and sudden cardiac death.This case report refers a case of aLQTS with TWA causing repeated ventricular fibrillation.It is an early warning electrocardiogram with increased risk of sudden death when multiple ECG phenomena occur simultaneously.Taking appropriate measures in time will reduce the risk of death to a certain extent.