Berkalp B, Baykal E, Caglar N, Erol C, Akgün G, Gürel T
Department of Cardiology, Ankara University School of Medicine, Kucukesat, Turkey.
Int J Cardiol. 1993 Dec 15;42(2):147-53. doi: 10.1016/0167-5273(93)90084-t.
The value of high frequency QRS potentials (HFQRS) during acute myocardial infarction (AMI) was assessed to define infarct size and prognosis. HFQRS were recorded by signal-averaged ECG with 150-250 Hz frequency ranges, using X, Y, Z orthogonal leads. Recordings were obtained in surviving AMI patients (n = 33, 12 inferior, 11 anterior, 10 anterior-inferior) on the first and tenth days, but in non-survived patients (n = 5, 2 inferior, 1 anterior, 2 anterior-inferior) only on the first day. Additionally, the frequency of ventricular tachycardia (VT) was evaluated by 24-h Holter monitoring in all patients at the same days. The control group consisted of 11 healthy people. In surviving AMI patients, RMS voltage of vector magnitude reduced in anterior and anterior-inferior MI but filtered QRS duration was longer in inferior MI than normals (P < 0.05, < 0.05, < 0.01, respectively). In nonsurvived patients, RMS voltages of leads X, Y, Z and vector magnitude were lower than normals (P < 0.01, < 0.05, < 0.01, < 0.01, respectively) and surviving AMI patients (P < 0.01, < 0.05, < 0.05, < 0.05, respectively), the filtered QRS duration was found to be longer than normals and survived patients (P < 0.01, < 0.01). In patients who had VT on Holter monitoring, filtered QRS duration was significantly longer than in patients without VT (P < 0.05). As a result, HFQRS was important for defining infarct size but not malignant ventricular arrhythmias. VT was related to filtered QRS duration. HFQRS may offer significant prognostic information and contribute to early risk stratification of AMI patients.
评估急性心肌梗死（AMI）期间高频QRS电位（HFQRS）以确定梗死面积和预后。使用X、Y、Z正交导联，通过频率范围为150 - 250Hz的信号平均心电图记录HFQRS。在存活的AMI患者（n = 33，其中下壁12例，前壁11例，前下壁10例）的第1天和第10天进行记录，但在未存活患者（n = 5，其中下壁2例，前壁1例，前下壁2例）仅在第1天进行记录。此外，在同一天通过24小时动态心电图监测评估所有患者的室性心动过速（VT）频率。对照组由11名健康人组成。在存活的AMI患者中，前壁和前下壁心肌梗死患者的向量幅度均方根（RMS）电压降低，但下壁心肌梗死患者的滤波QRS时限比正常时长（分别为P < 0.05、< 0.05、< 0.01）。在未存活患者中，导联X、Y、Z的RMS电压和向量幅度均低于正常（分别为P < 0.01、< 0.05、< 0.01、< 0.01）以及存活的AMI患者（分别为P < 0.01、< 0.05、< 0.05、< 0.05），发现滤波QRS时限比正常人和存活患者长（分别为P < 0.01、< 0.01）。在动态心电图监测发现有VT的患者中，滤波QRS时限显著长于无VT的患者（P < 0.05）。结果表明，HFQRS对于确定梗死面积很重要，但对恶性室性心律失常并非如此。VT与滤波QRS时限有关。HFQRS可能提供重要的预后信息，并有助于AMI患者的早期风险分层。
