预激综合征射频消融术后电张调整性 T波出现的规律

摘要

Objective : To investigate the rule of electrotonic: modulation of T wave (EMTW) after radiofrequency ablation (RFCA) in patients with preexcitation syndrome. Methods :The positions of the pathway were determined hy the electrophysiology test in 109 cases who had preexcitation syndrome. The 12-lead electrocardiogram (ECG) was recorded before and immediately after RFCA. The direction and magnitude of T wave were observed. The position and amplitude of EMTW were summarized and analyzed. Results: EMTW was detected in 78 of 109 patients with preexcitation syndrome. EMTW was found in right free wall and right posterior septum, which was mainly in inferior wall lead ( Ⅱ , Ⅲ and AVF) and high lateral wall lead ( Ⅰ and AVL). And T wave was inversed. The incidence of EMTW was also frequently found in the left anterior free wall, which mainly in the chest leads (V1-V6). There was significant difference in the amplitude of inferior wall lead at the right posterior f'ree wall (P ＜ 0.05). Conclusion : Appearance of EMTW in ECG after RFCA depends on the location of the pathway. EMTW is not all in reverse positive.%目的:探讨预激综合征患者在行射频消融术阻断旁道后电张调整性T波(EMTW)出现的规律.方法:109例不同旁道位置的显性预激综合征患者,根据电生理检查结果确定旁道位置,记录射频消融术前及术后即刻的常规12导联心电图,观察T波方向和幅度的变化,总结和分析EMTW出现的导联位置及幅度.结果:109例预激综合征患者在行射频消融术后有78例出现EMTW,右侧壁和右后间隔旁道消融后全部出现EMTW,主要分布于下壁导联(Ⅱ、Ⅲ、AVF)和高侧壁导联(Ⅰ、AVL),T波方向与QRS主波方向相反,为倒置型;左前侧壁旁道EMTW出现数日也较高,主要分布在胸前导联(V1～V6),多与QRS主波方向相同,为直立型.右后侧壁旁道位置上的下壁导联振幅Ⅲ、AVF导联高于Ⅱ导联,差别有统计学意义(P<0.05).结论:预激综合征患者在射频消融术后心电图的EMTW出现的导联及幅度与其旁道所在的位置关系密切,EMTW在方向上并不均是倒置的.