Burchell H B
Pediatr Cardiol. 1983 Apr-Jun;4(2):139-48. doi: 10.1007/BF02076339.
The growth of knowledge of the QT interval of the ECG is reviewed. 1980 was the centennial of the first careful measurements of Burdon-Sanderson and Page, and also the 60th anniversary of Bazett's contribution that established a predictable relation of the QT to heart rate in normal subjects. The waxing and waning of interest in the QT among clinical cardiologists appear to have been related to a low sensitivity and specificity of abnormal QT/rate ratios in many clinical diseases. The QT duration has been established as a valuable measurement, and sometimes the patterns may be nearly pathognomonic of electrolyte disturbances. Alterations from a predicted normal mean may give a clue to disease. The importance of transient dissociation of the predicted QT from the measured QT with rapid changes in heart rate deserves further emphasis. In the publication of data on the duration of QT, the reporting only of the corrected QT (QTc), the index of Bazett, conveys an incomplete picture of the nature of the changes. The prolonged QT pattern in adults should be suspected of being related to drugs first, except when a neurogenic cause is apparent. The idiopathic hereditary syndrome still defies a completely adequate explanation, though neurogenic influences are overtly important. No universal management has been established.
本文回顾了心电图QT间期相关知识的发展历程。1980年是Burdon - Sanderson和Page首次进行精确测量的一百周年，同时也是Bazett提出正常受试者QT与心率可预测关系的六十周年。临床心脏病学家对QT间期的关注度起伏，似乎与许多临床疾病中QT/心率比值异常的低敏感性和特异性有关。QT间期已被确认为一项有价值的测量指标，有时其模式可能近乎是电解质紊乱的特征性表现。与预测的正常均值的偏差可能为疾病提供线索。心率快速变化时预测QT与测量QT的短暂分离的重要性值得进一步强调。在公布QT间期数据时，仅报告校正QT（QTc，即Bazett指数）并不能完整呈现变化的本质。成人出现QT延长模式时，首先应怀疑与药物有关，除非明显存在神经源性病因。尽管神经源性影响显然很重要，但特发性遗传综合征仍难以得到完全充分的解释。目前尚未确立通用的治疗方法。
