长QT综合征发生尖端扭转型室性心动过速时初始节律的研究  

Investigation of Initial Rhythm Preceding the Onset of Torsade de Pointes Ventricular Tachycardia in Long QT Syndrome

作　　者：孙华群[1] 郑新权[1] 黄小芳[1] 李忠杰[1] 

机构地区：[1]浙江省人民医院心电图室,杭州市310014

出　　处：《心电学杂志》2011年第3期226-228,共3页Journal of Electrocardiology(China)

摘　　要：目的 比较先天性与获得性长QT综合征（LQTS）发生尖端扭转型室性心动过速（TdP）时的初始节律.方法分析6例先天性LQTS、8例获得性LQTS的Q-TC间期、校正的Tp-e间期（Tp-eC）及TdP发生阵数、初始节律.结果6例先天性LQTS中,Q-TC间期（565.2± 45.1）ms,Tp-eC（145.1±29.1）ms,共计Tdp14阵,平均2.3阵/例,TdP发作前可见窦性节律加快、频发室性期前收缩或室性心动过速.8例获得性LQTS中,Q-TC间期（591.3±67.3）ms,Tp-eC（154.2±56.9）ms,共计TdP237阵,平均29.6阵/例,TdP发生在缓慢节律的基础上频发室性期前收缩,呈短-长-短形式触发.结论获得性LQTS比先天性LQTS更具有危险性,TdP发生前的初始节律分析有助于鉴别先天性LQTS和获得性LQTS及指导临床治疗.Objective To compare the initial rhythm preceding the onset of Torsade de Pointes （TdP） between congenital and acquired long QT syndrome（LQTS）. Methods The corrected Q-T interval（Q-Tc）,the corrected Tpeak to end interval（Tp-ec） and TdP were analyzed in 6 congenital LQTS and 8 acquired LQTS. Results The Q-Tc was 565.2 ~ 45.1 ms, Tp-ec was 145.1 ± 29.1 ms and 14 episodes of TdP （average 2.3 episodes per case） were recorded in 6 congenital LQTS. Accelerated sinus rhythm, frequent ventricular extrasystole or ventricular tachycardia was seen preceding the onset of TdP in congenital LQTS. The Q-Tc was 591.3 ± 67.3 ms, Tp-ec was 154.2 ± 56.9 ms and 237 episodes of TdP （29.6 episodes per case） were recorded in 8 acquired LQTS. The onset of TdP was preceded by a short-long-short cycle due to a ventricular extrasystole and a slow rhythm in acquired LQTS. Conclusion Acquired LQTS is associated with a higher risk of TdP compared to congenital LQTS. An analysis of Initial rhythm preceding the onset of TdP may be useful in identifying congenital and acquired LQTS.

关 键 词：尖端扭转型室性心动过速 先天性LQTS 获得性LQTS 初始节律 

分 类 号：R541.71[医药卫生—心血管疾病]