经皮腔内室间隔心肌消融术对心电指标的影响  

Influences of percutaneous transluminal septal myocardial ablation on electrocardiographic data

作　　者：朱汉东[1] 王人彭[1] 苏唏[1] 万海燕[1] 彭剑[1] 宋丹[1] 陈国洪[1] 朱国英[1] 

机构地区：[1]武汉亚洲心脏病医院心内科,湖北武汉430022

出　　处：《生物医学工程与临床》2006年第4期223-225,共3页Biomedical Engineering and Clinical Medicine

摘　　要：目的研究肥厚梗阻型心肌病患者经皮腔内室间隔心肌消融术对心电指标的影响。方法对50例肥厚梗阻型心肌病患者行经皮腔内室间隔心肌消融术,记录术前、术中和术后出现的心律失常类型,配对分析术前、术后心电指标的变化。结果术后与术前相比,QRS时限[(122.0±24.0)ms对(97.3±15.5)ms,P=0.000]明显延长,QTc[(469.3±32.2)ms对(434.3±41.5)ms,P=0.004]、PR间期[(169±26)ms对(162±24)ms,P=0.044]稍延长。术中心律失常发生率分别为:右束支传导阻滞70%(35/50),左束支传导阻滞8%(4/50),一过性AVB38%(19/50),频发室性早搏24%(12/50),短阵室性心动过速24%(12/50);未发生持续性室性心动过速和室颤。术后心律失常发生率分别为:右束支传导阻滞56%(28/50),左束支传导阻滞8%(4/50),交界区性心动过速4%(2/50),频发室性早搏16%(8/50),短阵室性心动过速8%(4/50)。无永久性起搏器植入及死亡病例。结论经皮腔内室间隔心肌消融术致心律失常的发生率高,右束支传导阻滞最为常见。严格选择适应证后谨慎地行PTSMA术是安全、可行的。Objective To study the influences of percutaneous transluminal septal myocardial ablation （PTSMA） on electrocardiographic data in patients with hypertrophic obstructive cardiomyopathy （HOCM）, Methods The PTSMA was performed in 50 patients with HOCM. Arrhythmias were recorded during and after PTSMA. The electrocardiographic data were compared the before with after PTSMA. Results ComparedtobeforePTSMA,theQRSduration[（122.0±24.0） msvs （97.3± 15.5） ms,P= 0.000] increased significantly, QTc [（469.3 ± 32.2） ms vs （434.3 ± 41.5 ） ms,P = 0.004] and PR intervals[（ 169 ± 26） ms vs （162 ± 24） ms,P = 0.044] increased mildly. During PTSMA,right bundle branch block was developed in 35 patients（70 %）,left bundle branch block in 4 patients （8 %）, temporal AVB in 19 （38 %）,frequent ventricular extrasystole in 12（24 %）,paroxysmal ventricular tachycardia in 12 （24 %）, no sustain VT and Vf were found. After PTSMA, right bundle branch block was developed in 28 patients （56 %）,left bundle branch block in 4 patients（8 %）, paroxysmal junctional tachycardia in 2（4 %）, frequent ventricular extrasystole in 8（16 %）,paroxysmal ventricular tachycardia in 4（8 %）. Conclusion The frequency of arrythmias induced by PTSMA is high and occurrence of right bundle branch block is most common.

关 键 词：经皮腔内室间隔心肌消融术 肥厚梗阻型心肌病 心律失常 

分 类 号：R542.2[医药卫生—心血管疾病]