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在一名心脏性猝死复苏患者中，乙酰胆碱用于冠状动脉痉挛激发试验时J波的表现。

Manifestation of J wave induced by acetylcholine applied for a coronary spasm provocation test in a patient with aborted sudden cardiac death.

作者信息

Kodama Hiroyuki, Fujita Kazumasa, Moriyama Shouhei, Irie Kei, Noda Hirotaka, Yokoyama Taku, Fukata Mitsuhiro, Arita Takeshi, Odashiro Keita, Maruyama Toru, Akashi Koichi

机构信息

Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.

出版信息

J Arrhythm. 2017 Jun;33(3):234-236. doi: 10.1016/j.joa.2016.09.001. Epub 2016 Nov 23.

DOI:10.1016/j.joa.2016.09.001
PMID:28607620
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5459330/
Abstract

A 51-year-old man with a resuscitation episode was referred to our hospital. Coronary angiography revealed a focal spasm overlapped with organic stenosis where a bare metal stent was implanted. Acetylcholine (ACh) provocation test did not induce chest pain. It revealed no discernible ST-T changes but unmasked a J wave at the end of the QRS complex, which was associated with short-coupled repetitive premature ventricular beats. A J wave reportedly appears immediately before the onset of ventricular fibrillation caused by vasospastic angina. However, a J wave observed newly after a coronary spasm provocation test using ACh without ST-T changes is informative when considering the mechanisms of the J wave.

摘要

一名经历过复苏事件的51岁男性被转诊至我院。冠状动脉造影显示局灶性痉挛与植入裸金属支架的器质性狭窄重叠。乙酰胆碱（ACh）激发试验未诱发胸痛。试验未显示出明显的ST-T改变，但在QRS波群末端出现了一个J波，该J波与短联律重复性室性早搏相关。据报道，J波出现在血管痉挛性心绞痛引起的心室颤动发作之前。然而，在使用ACh进行冠状动脉痉挛激发试验后新出现的、无ST-T改变的J波，在考虑J波的发生机制时具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9296/5459330/5058ba8e8172/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9296/5459330/4cc92d6d5edd/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9296/5459330/5058ba8e8172/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9296/5459330/4cc92d6d5edd/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9296/5459330/5058ba8e8172/gr2.jpg

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本文引用的文献

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Relationship between J Waves and Vagal Activity in Patients Who Do Not Have Structural Heart Disease.无结构性心脏病患者J波与迷走神经活动的关系。
Ann Noninvasive Electrocardiol. 2015 Sep;20(5):464-73. doi: 10.1111/anec.12302. Epub 2015 Aug 25.
2
Vasospastic angina with J waves formation in patients with sudden loss of consciousness.意识突然丧失患者出现伴有J波形成的血管痉挛性心绞痛。
J Geriatr Cardiol. 2015 May;12(3):313-8. doi: 10.11909/j.issn.1671-5411.2015.03.016.
3
Mechanisms underlying the development of the electrocardiographic and arrhythmic manifestations of early repolarization syndrome.
早期复极综合征心电图和心律失常表现发展的机制。
J Mol Cell Cardiol. 2014 Mar;68:20-8. doi: 10.1016/j.yjmcc.2013.12.012. Epub 2013 Dec 28.