Simonsen E
Dan Med Bull. 1985 May;32(2):123-6.
Changes of T waves and ST segments in normally conducted beats are frequently seen in patients treated with ventricular demand pacing. The alteration in the sequence of ventricular activation is accompanied by inversion of T waves and sometimes a depression of ST segments in several leads. These changes have a close resemblance to those often seen in ischaemic heart disease. Some of the clinical implications are illustrated in four case stories. The slow regression of changes after cessation of pacing is particularly emphasised. The time required for complete disappearance of changes was directly related to the duration of ventricular pacing. In contrast to this finding a quickly developed, though temporary, regression was observed during exercise. The development of repolarisation changes requires a certain duration and extent of pacing. Therefore changes are not present in all ventricular paced patients. Consequently, recording of the spontaneous rhythm is proposed as a routine in the pacemaker clinic. The recordings might prove valuable for future comparison in case of suspected myocardial disease.
在接受心室按需起搏治疗的患者中，常可见到正常传导搏动时T波和ST段的改变。心室激动顺序的改变伴有T波倒置，有时在多个导联出现ST段压低。这些改变与缺血性心脏病中常见的改变极为相似。四个病例说明了其中一些临床意义。特别强调了起搏停止后这些改变的缓慢消退。改变完全消失所需的时间与心室起搏的持续时间直接相关。与此发现相反，在运动期间观察到改变迅速出现，尽管是暂时的，随后消退。复极改变的发生需要一定的起搏持续时间和程度。因此，并非所有心室起搏患者都会出现这些改变。因此，建议在起搏器门诊常规记录自发心律。对于疑似心肌病的情况，这些记录可能对未来的比较有价值。
