Rozanski J J, Kleinfeld M
Pacing Clin Electrophysiol. 1980 Nov;3(6):724-9. doi: 10.1111/j.1540-8159.1980.tb05577.x.
In a study of 93 patients who met criteria for Prinzmetal's angina, alternans of the ST segment was observed in 28 of 93 patients (30%). In 8 of these 28 patients, a hitherto undescribed variant of alternans, namely alternation (larger than or equal to 1 mm shift in 2:1 pattern) in the amplitude of the baseline or TQ segment (TQ Alt) was observed. In all eight patients serious ventricular arrhythmias were noted, namely, ventricular fibrillation in two, ventricular tachycardia in four, and multiform or advanced ventricular ectopic activity in eight. The TQ Alt developed only after ST segment alternans occurred. It is postulated that the alternations of the ST and TQ segments are due to differences in current flows due to inhomogeneity of depolarization and repolarization of the action potential caused by ischemia. Furthermore, the associated arrhythmias observed are related to the inhomogeneous state initiated by the ischemia.
在一项针对93例符合变异型心绞痛标准患者的研究中，93例患者中有28例（30%）观察到ST段交替变化。在这28例患者中的8例中，观察到一种迄今未描述的交替变化变体，即基线或TQ段（TQ Alt）幅度的交替变化（2:1模式下移位大于或等于1毫米）。在所有8例患者中均记录到严重室性心律失常，即2例心室颤动、4例室性心动过速以及8例多形性或复杂性室性早搏。TQ Alt仅在ST段交替变化出现后才发生。据推测，ST段和TQ段的交替变化是由于缺血导致动作电位去极化和复极化不均匀而引起的电流差异所致。此外，观察到的相关心律失常与缺血引发的不均匀状态有关。
