Davy J M, Piot C, Beck L, Raczka F
CHU, hôpital Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier.
Arch Mal Coeur Vaiss. 2001 Mar;94 Spec No 2:51-8.
A simple ECG curiosity or a precursor of serious arrhythmia, associated with pericardial effusion or a sign of inotropic alteration, the phenomenon of electrical alternans has intrigued clinicians and research workers in its multiple facets, mechanical and electrical, consequences on PR interval, QRS complex or ventricular repolarisation. As a consequence, the causal mechanisms are very different, but these last few years, a predominant role of calcium flux, especially intracellular, has been demonstrated. Recently, clinical interest in this phenomenon has been revived with the demonstration of micro-alternans of repolarisation, apparently a new marker for the risk of sudden death.
电交替现象是一种单纯的心电图奇象，还是严重心律失常的先兆，与心包积液相关，或是心肌收缩性改变的体征？它在机械和电学方面的多个层面，以及对PR间期、QRS波群或心室复极化的影响，一直吸引着临床医生和研究人员。因此，其因果机制差异很大，但在过去几年中，已证明钙流尤其是细胞内钙流起主要作用。最近，随着复极化微交替现象的证实，临床上对这一现象的兴趣再度兴起，复极化微交替现象显然是猝死风险的一个新标志物。
