Yanagawa T, Hirai M, Hayashi H, Sano H, Tomita Y, Inden Y, Saito H
First Department of Internal Medicine, University of Nagoya School of Medicine, Japan.
J Am Coll Cardiol. 1995 Jun;25(7):1584-90. doi: 10.1016/0735-1097(95)00094-k.
We investigated the usefulness of QRST values obtained from 12-lead electrocardiograms (ECGs) for identification of repolarization abnormalities before and after radiofrequency ablation in patients with Wolff-Parkinson-White syndrome.
Marked T wave abnormalities often appear after ablation and have been attributed to a continuation of repolarization abnormalities present before ablation (cardiac memory). However, to our knowledge repolarization properties before and after ablation have not been assessed quantitatively.
We calculated the ECG QRST values from 53 patients with Wolff-Parkinson-White syndrome and compared these values before, immediately after and 1 day and 1 week after successful ablation in 25 patients.
QRST values were abnormally high in lead V1 in 7 of 28 patients with a left-sided accessory pathway and abnormally low in leads III and aVF and high in lead aVL in 12, 9 and 10 of 20 patients, respectively, with a right-sided accessory pathway. Preexisting QRST abnormalities were still present immediately and 1 day after ablation but were usually absent by 1 week after ablation. QRST values before, immediately after and 1 day after ablation were not significantly different in any lead. In 14 patients with ablation of a left-sided accessory pathway, QRST values before, immediately after and 1 day after ablation in lead V1 and immediately after ablation in leads I, aVR and V2 were significantly different from QRST values in those leads 1 week after ablation. In six patients with ablation of a right-sided accessory pathway, QRST values before, immediately after and 1 day after ablation in leads III, aVL and aVF and immediately after ablation in lead II were significantly different from QRST values in those leads 1 week after ablation.
Electrocardiographic QRST values may provide useful quantitative information with respect to repolarization properties before and after ablation in patients with Wolff-Parkinson-White syndrome that is otherwise difficult to obtain by conventional ECG analysis.
我们研究了从12导联心电图（ECG）获得的QRST值在识别预激综合征患者射频消融前后复极异常方面的有用性。
明显的T波异常常在消融后出现，并被归因于消融前存在的复极异常的延续（心脏记忆）。然而，据我们所知，消融前后的复极特性尚未进行定量评估。
我们计算了53例预激综合征患者的心电图QRST值，并比较了25例成功消融患者在消融前、消融后即刻、消融后1天和1周时的这些值。
28例左侧旁路患者中，7例V1导联的QRST值异常高；20例右侧旁路患者中，分别有12例、9例和10例在III导联、aVF导联QRST值异常低，在aVL导联QRST值高。消融前存在的QRST异常在消融后即刻和1天仍存在，但通常在消融后1周消失。消融前、消融后即刻和消融后1天，任何导联的QRST值均无显著差异。在14例左侧旁路消融患者中，消融前、消融后即刻和消融后1天V1导联以及消融后即刻I导联、aVR导联和V2导联的QRST值与消融后1周时这些导联的QRST值显著不同。在6例右侧旁路消融患者中，消融前、消融后即刻和消融后1天III导联、aVL导联和aVF导联以及消融后即刻II导联的QRST值与消融后1周时这些导联的QRST值显著不同。
心电图QRST值可能为预激综合征患者消融前后的复极特性提供有用的定量信息，而这些信息通过传统心电图分析难以获得。
