Kraska T, Opolski G, Słomka K, Stanisławska J
Kliniki Kardiologii Instytutu Chorób Wewnetrznych AM w Warszawie.
Pol Tyg Lek. 1990;45(1-3):13-6.
The study involved 150 patients with recent myocardial infarction. Ventricular lat potentials were registered in these patients during the first 48 hours and repeated in the third week. Ventricular late potentials were found in 31 patients (21%) in the first 48 hours, and in 27 out of 134 patients (20%) before the release from the hospital. Comparing potentials registration in the acute and late phase of the myocardial infarction it was found that ventricular late potentials occurred in 6 and disappeared in 4 patients. Stable ventricular tachycardia was significantly more frequent (p less than 0.001) within the first 48 hours in patients with ventricular late potentials than those without them (19% vs 3%). Ventricular late tachycardia (over 48 hours) was more frequent (p less than less than 0.001) in patients with ventricular late potentials (21% vs 1%). Premature ventricular excitations of Lown class 2-5 were also more frequent (p less than 0.001) in the group of patients with ventricular late potentials than those without these potential (81% vs 24%) when registered with a 24-hour Holter ECG in the third week following myocardial infarction. Antiarrhythmic drugs did not produce the regression of ventricular late potentials. Non-invasive registration of ventricular late potentials helps to select patients with life-threatening ventricular arrhythmias following the acute myocardial infarction.
该研究纳入了150例近期发生心肌梗死的患者。在这些患者发病后的头48小时内记录心室晚电位,并在第三周重复记录。在头48小时内,31例患者(21%)检测到心室晚电位,在出院前,134例患者中有27例(20%)检测到心室晚电位。对比心肌梗死急性期和后期的电位记录发现,有6例患者出现心室晚电位,4例患者的心室晚电位消失。在发病后头48小时内,有心室晚电位的患者发生持续性室性心动过速的比例显著高于无心室晚电位的患者(19% 对3%,p<0.001)。有心室晚电位的患者发生心室晚发性心动过速(超过48小时)的比例更高(21% 对1%,p<<0.001)。在心肌梗死后第三周进行24小时动态心电图监测时,有心室晚电位的患者出现洛恩2 - 5级室性早搏的比例也高于无心室晚电位的患者(81% 对24%,p<0.001)。抗心律失常药物并不能使心室晚电位消退。心室晚电位的无创记录有助于筛选急性心肌梗死后有危及生命的室性心律失常的患者。