Murda'h M A, McKenna W J, Camm A J
Department of Cardiological Sciences, St. George's Hospital Medical School, London, United Kingdom.
Pacing Clin Electrophysiol. 1997 Oct;20(10 Pt 2):2641-57. doi: 10.1111/j.1540-8159.1997.tb06113.x.
Sudden cardiac death continues to be the leading cause of mortality in developed countries. Electrical alternans of the ST segment and the T wave on the surface ECG as a noninvasive marker of patients at risk is a phenomenon that was initially observed early in this century and was seen then to be associated with cardiac rhythm disturbances. Substantial evidence indicates that T wave alternans (TWA) is related to myocardial ischemic as a harbinger of malignant ventricular arrhythmias because it reflects dispersion and heterogeneity of repolarization. Recent data have demonstrated a significant correlation between TWA and vulnerability to ventricular arrhythmias in individuals with or without organic heart disease, it also predicts the results of electrophysiological testing and arrhythmia-free survival in patients with a variety of cardiac diseases. This article reviews the historical background of TWA and discusses the early experimental and recent clinical evidence implying an integral link between TWA and ischemia-induced cardiac vulnerability.
心脏性猝死仍然是发达国家的主要死亡原因。体表心电图上ST段和T波的电交替作为有风险患者的非侵入性标志物，是一种在本世纪初首次被观察到的现象，当时被认为与心律失常有关。大量证据表明，T波电交替（TWA）作为恶性室性心律失常的先兆与心肌缺血有关，因为它反映了复极的离散和异质性。最近的数据表明，无论有无器质性心脏病，TWA与个体室性心律失常的易感性之间都存在显著相关性，它还可以预测各种心脏病患者的电生理测试结果和无心律失常生存期。本文回顾了TWA的历史背景，并讨论了早期实验和近期临床证据，这些证据表明TWA与缺血性心脏易损性之间存在内在联系。
