特发性左心室心动过速后心脏记忆T波改变与急性冠状动脉综合征所致缺血性T波倒置之间的差异。
Differences between cardiac memory T wave changes after idiopathic left ventricular tachycardia and ischemic T wave inversion induced by acute coronary syndrome.
作者信息
Nakagawa Takashi, Yagi Tetsuo, Ishida Akihiko, Mibiki Yoshiaki, Yamashina Yoshihiro, Sato Hirokazu, Sato Eiji, Komatsu Juri, Saijo Yoshifumi
机构信息
Division of Cardiology, Sendai City Hospital, Sendai, Japan; Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan.
Division of Cardiology, Sendai City Hospital, Sendai, Japan.
出版信息
J Electrocardiol. 2016 Jul-Aug;49(4):596-602. doi: 10.1016/j.jelectrocard.2016.04.001. Epub 2016 Apr 22.
BACKGROUND
Cardiac memory (CM) after idiopathic left ventricular tachycardia (ILVT) mimics ischemic T wave inversion (TWI) induced by acute coronary syndrome (ACS). We aimed to establish electrocardiography criteria for differentiating the CM from ischemic TWI.
METHODS AND RESULTS
We evaluated 16 ILVT and 48 ACS patients. We identified TWI after ILVT in 9/16 patients (CM group), typically in leads II, III, aVF, aVR, and V4-6. The characteristics of CM were similar to TWI induced by ACS involving right coronary artery, but the CM group had more TWI in V4 and shorter QTc. The criteria of (1) positive T in aVL, (2) negative or isoelectric T in II, and (3) negative T in V4-6 or (4) QTc <430ms were 100% sensitive and 96% specific for the CM group.
CONCLUSION
CM after ILVT can be differentiated in most cases from ischemic TWI by the distribution of TWI and the QTc.
背景
特发性左心室心动过速（ILVT）后的心脏记忆（CM）类似于急性冠状动脉综合征（ACS）引起的缺血性T波倒置（TWI）。我们旨在建立区分CM与缺血性TWI的心电图标准。
方法和结果
我们评估了16例ILVT患者和48例ACS患者。我们在9/16例患者（CM组）中发现ILVT后出现TWI，典型地出现在II、III、aVF、aVR和V4-6导联。CM的特征与右冠状动脉受累的ACS引起的TWI相似，但CM组V4导联的TWI更多且QTc更短。（1）aVL导联T波正向，（2）II导联T波负向或等电位，（3）V4-6导联T波负向，或（4）QTc<430ms的标准对CM组的敏感性为100%，特异性为96%。
结论
ILVT后的CM在大多数情况下可通过TWI的分布和QTc与缺血性TWI相鉴别。
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