阵发性折返性室上性窄QRS波心动过速终止后倒置T波的临床意义

Significance of newly acquired negative T waves after termination of paroxysmal supraventricular tachycardia with narrow QRS complex

目的 :研究阵发性折返性室上性窄QRS波心动过速终止后倒置T波的临床意义。方法 :对 71例自发折返性 (房室结折返或房室折返 )室上性窄QRS波心动过速终止后倒置T波的患者行运动心电图试验、运动铊心肌灌注显像及冠状动脉造影。结果 :心动过速终止后 ,30例 (4 2 .3% )出现倒置T波 ,均行运动心电图试验 ,5例呈阳性改变的病例行运动铊心肌灌注显像 ,3例呈铊阳性改变的病例冠状动脉造影显示 1支血管管腔直径≥75 %的明显狭窄 ,但均无冠心病的临床表现。结论 :阵发性折返性室上性窄QRS波心动过速终止后倒置T波代表一种常见的现象 ,可能持续存在一段时间 ,根据常见的临床和心电图指标不能预测其是否发生。

Objective:To investigate the clinical significance of newly acquired negative T waves after termination of paroxysmal supraventricular reentrant tachycardia with narrow QRS complex.Method:Thirty patients showing this repolarization abnormality underwent a exercise ECG test, exercise thallium scintigraphy and coronary angiography.Result:Five of the 30 patients with newly acquired negative T waves after tachycardia termination had ECG findings indicating myocardial ischemia with in exercise test thallium scintigraphy showed the possitive finding in 3 patients. Coronary angiography showed a significant stenosis( ≥75% diameter narrowing) of 1 vessel in one of three. But they did not show symptoms of coronary artery disease.Conclusion:It is common finding for newly acquired negative T waves after termination of paroxysmal supraventricular reentrant tachycardia with narrow QRS complex it can not predictable based on clinical characterstic or ECG findings. Coronary artery disease does not to be related this repolarization abnormality.