巨大Epsilon波致心律失常性右室心肌病临床和心电图特点  

Clinical characteristics of arrhythmogenic right ventricular cardiomyopathy accompanied with giant epsilon wave

作　　者：谢启应[1] 杨天伦[1] 井然[1] 马静[1] 易军[1] 孙泽琳[1] 

机构地区：[1]中南大学湘雅医院心内科,湖南长沙410008

出　　处：《中国心脏起搏与心电生理杂志》2016年第2期127-130,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的总结心电图表现为巨大Epsilon波致心律失常右室心肌病(ARVC)患者的临床和心电图特点。方法分析本院于2011年1月至2014年12月收治的12导联心电图示巨大Epsilon波ARVC患者的临床和心电图特点。通过查询Medline、CNKI、VIP和万方数据库等总结该心电图特征ARVC患者的特点。结果 5例患者中男性4例。首发症状均为心悸、头昏。发作时心电图为右室起源室性心动过速。心脏超声示右室扩大;右室壁变薄,可见小凹。心电图V_1导联QRS呈"M"型;巨大Epsilon波振幅为(0.37±0.16)mV,振幅与S波比值为1.20±0.23;持续时间为(90±12.75)ms,持续时间与QRS波相比为0.60±0.06。文献报道5例患者均为男性。临床表现为心悸,晕厥发作。心电图V_1导联QRS均呈rsR′,Fontain导联、心向量和晚电位证实该R′波为Epsilon波。V_1导联Epsilon波振幅为(0.52±0.35)mV,振幅与S波比值为1.18±0.74;持续时间(96.0±11.4)ms,持续时间与QRS波相比为0.65±0.08。结论临床上巨大Epsilon波ARVC患者少见,右室激动延缓,心律失常发生率高。Objective To assess the clinical characteristics and electrocardiogram of arrhythmogenic right ventricu- lar cardiomyopathy （ARVC） accompanied with giant epsilon wave. Methods Five ARVC patients accompanied with giant epsilon wave during 2011 Jan and 2014 Dec were enrolled. Literatures were collected by searching the da- tabase of Pubmed, CNKI, VIP and Wanfang. Data of clinical characteristics and electrocardiogram were collected. Results Palpitation and dizziness were the common clinical manifestation. Enlarged right ventricle and thin ven- tricular wall accompanying with fovea were showed in echocardiography. M type morphology was showed in lead V1. The amplitude of giant epsilon wave were（0. 37±0.16）mV and the last time were （90 ± 12.75）ms. A total 5 cases with palpitation and syncope had been reported previously. The morphology of QRSv1 was rsR＇ in all cases, The amplitude of giant epsilon wave were （0.52±0.35）mV and the last time were（96.0± 11.4）ms. Conclusion ARVC accompanied with giant epsilon wave may show very late right ventricular propagation and high incidence of ventricular arrhythmia. [Chinese Journal of Cardiac Pacing and Electrophysiology ,2016,30（2） ：127-130]

关 键 词：心血管病学 巨大Epsilon波 致心律失常右室心肌病 心电图 EPSILON波 特点 

分 类 号：R540.41[医药卫生—心血管疾病] R542.2[医药卫生—内科学]