Izumida N, Asano Y, Kiyohara K, Doi S, Hatai Y, Tsuchiya S, Hosaki J, Kawano S, Sawanobori T, Hiraoka M
Department of Pediatrics, School of Medicine, Tokyo Medical and Dental University, Japan.
J Electrocardiol. 1995 Jul;28(3):223-9. doi: 10.1016/s0022-0736(05)80260-2.
To elucidate the mechanism of electrocardiographic changes due to right ventricular pressure overload, serial changes on body surface maps recorded in two children with valvular pulmonary stenosis before and after successful reduction of right ventricular pressure by balloon valvuloplasty (BVP) were studied. Body surface maps and 12-lead electrocardiograms were simultaneously recorded before and 1-1.5 hours, 8 hours, and 5 days after BVP. Before BVP, QRST isointegral maps showed either two maxima or an expanded single maximum on the right anterior chest. These abnormal characteristics become normal or near normal 1-1.5 hours after BVP. Electrocardiographic waveforms and QRS and ST-T isointegral maps showed minimal changes. Changes in QRST isointegral maps were observed near the center of the midanterior chest. These results suggest that increased right ventricular pressure caused a primary repolarization abnormality in the mid-anterior chest that was easily detected by body surface QRST isointegral maps.
为阐明右心室压力超负荷导致心电图改变的机制，我们研究了两名瓣膜性肺动脉狭窄患儿在成功进行球囊瓣膜成形术（BVP）降低右心室压力前后体表心电图的系列变化。在BVP术前、术后1 - 1.5小时、8小时和5天同时记录体表心电图和12导联心电图。BVP术前，QRST等积分图显示右前胸有两个最大值或一个扩大的单一最大值。这些异常特征在BVP术后1 - 1.5小时变为正常或接近正常。心电图波形以及QRS和ST - T等积分图显示变化极小。在前胸中部中心附近观察到QRST等积分图的变化。这些结果表明，右心室压力升高导致前胸中部出现原发性复极异常，体表QRST等积分图可轻易检测到这种异常。
