T波电交替预测缺血性心脏病心脏性猝死的临床意义

摘要

中国每年心脏性猝死人数约54.4万人，主要病因为缺血性心脏病所致恶性心律失常，所以及时有效检测减少心脏性猝死发生对降低心血管病病死率有重要意义。2008年AHA／ACC／HRS联合发表了“无创技术对心脏性猝死危险分层的专家共识”，指出用于识别心脏性猝死高危患者的无创检测指标，包括常规心电图、平均信号心电图、动态心电图、心电图运动试验（T波电交替）及压力感受器敏感性等。其中T波电交替为心电图上ST段或T波形态及振幅变化现象，是一种心电活动不稳定现象，具有在临床应用、随访复查方面更为方便灵活，操作简单及较高阳性识别率等特点，成为预测缺血性心脏病致恶性心律失常及心脏性猝死的主要无创性检测指标之一。%The number of sudden cardiac death in China is about 54.4 million people each year, and the main reason is malignant ar-rhythmias caused by ischemic heart disease, so it does significantly to reduce the incidence of sudden cardiac death and cardiovascular mor-tality by predicting timely and effectively.In 2008, AHA/ACC/HRS published ‘Expert consensus on risk stratification of sudden cardiac death through non-invasive techniques’ , which pointed out non-invasive methods were ECG, ventricular late potential, Holter, T-wave alter-nans, and baroneflex sensitivity.T-wave alternans is instability of electrical activity ECG phenomenon, on which ST segment or T wave mor-phology and amplitude changes, which is more convenient and flexible used in clinical or follow-up, and becomes one of major non-invasive detections of indicators of malignant arrhythmias and sudden cardiac death.