Denereaz D, Zimmermann M, Adamec R
Cardiology Center, University Hospital, Geneva, Switzerland.
Eur Heart J. 1992 Jul;13(7):895-901. doi: 10.1093/oxfordjournals.eurheartj.a060289.
To assess the incidence and clinical significance of ventricular late potentials in non-ischaemic dilated cardiomyopathy, 51 consecutive (44 male, seven female, mean age 53 +/- 11 years) patients with dilated cardiomyopathy were studied. Twenty-eight patients (55%) were in New York Heart Association functional class III or IV, 34 out of 51 (76%) had a left ventricular ejection fraction of less than 40%, 10 out of 51 (20%) had a history of sustained ventricular tachycardia (VT), 24 out of 37 (65%) had runs of non-sustained ventricular tachycardia during Holter monitoring and 15 out of 51 (29%) had a left bundle branch block. A signal-averaged electrocardiogram (gain 10(6) x, bipolar chest leads, filters 100-300 Hz) was performed in all the patients; late potentials were considered present if the total filtered QRS duration was longer than 118 ms and the interval between the end of QRS and the voltage 40 microV was more than 40 ms in the absence of left bundle branch block (total filtered QRS duration greater than 140 ms and interval between the end of QRS and the voltage 40 microV greater than 50 ms in the presence of left bundle branch block). Ventricular late potentials were detected in 22 out of 51 patients (43%). Late potentials were present in 80% (eight out of 10) of patients with sustained ventricular tachycardia but in only 34% (14 of 41) without sustained ventricular tachycardia (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
为评估非缺血性扩张型心肌病中心室晚电位的发生率及临床意义,对51例连续的(44例男性,7例女性,平均年龄53±11岁)扩张型心肌病患者进行了研究。28例患者(55%)处于纽约心脏协会心功能Ⅲ或Ⅳ级,51例中有34例(76%)左心室射血分数低于40%,51例中有10例(20%)有持续性室性心动过速(VT)病史,37例中有24例(65%)在动态心电图监测时有非持续性室性心动过速发作,51例中有15例(29%)有左束支传导阻滞。对所有患者进行了信号平均心电图检查(增益10(6)x,双极胸导联,滤波器100 - 300Hz);在无左束支传导阻滞时,若总滤波QRS时限长于118ms且QRS终末至电压40μV的间期大于40ms(存在左束支传导阻滞时,总滤波QRS时限大于140ms且QRS终末至电压40μV的间期大于50ms),则认为存在晚电位。51例患者中有22例(43%)检测到心室晚电位。有持续性室性心动过速的患者中80%(10例中的8例)存在晚电位,而无持续性室性心动过速的患者中仅34%(41例中的14例)存在晚电位(P<0.01)。(摘要截断于250字)