论文部分内容阅读
目的碎裂QRS波(fragmented QRS complex,fQRS)是近年来新提出的无创心电学指标,其发生与心肌疤痕形成所导致的心电传导延迟和异常有关,常见于冠心病、心肌病,特别是心肌梗死患者。但fQRS波与恶性室性心律失常发生有关报道甚少,且fQRS波做为心梗后判断预后的指标亦有不同的研究结果。为此本文观察老年人心梗后fQRS波与室性心律失常的关系。方法对54例老年心肌梗死后常规和动态心电图以及临床资料进行分析。根据有无fQRS波分为2组,有fQRS波组29例;无fQRS波组25例。并对fQRS波阳性合并室性心律失常患者ICD植入后放电治疗情况进行随访。结果 1老年人心梗后碎裂QRS波发生率约为53.7%(29/54);2有fQRS波组心力衰竭的发生率(9/29)显著高于非fQRS波组(2/25)(31.1%vs.8.0%,P<0.05)。3有fQRS波组室性心律失常的发生率(13/29)显著高于非fQRS波组(4/25)(44.8%vs.16.0%,P<0.05)。4在有fQRS波组中严重室性心律失常8例,5例非持续性室速患者植入ICD,在6~18个月随访中均有数次成功放电治疗。结论fQRS波与心梗后室性心律失常发生密切相关,fQRS波对老年人心梗后室性心律失常预测有一定价值。
Objective Fragmentation QRS complex (fQRS) is a new noninvasive electrocardiogram (ECG) newly proposed in recent years. Its occurrence is related to the delay and abnormality of ECG conduction caused by myocardial scar formation. It is common in coronary heart disease, cardiomyopathy, especially Myocardial infarction patients. But fQRS wave and malignant ventricular arrhythmias rarely reported, and fQRS wave as a marker of prognosis after myocardial infarction also have different findings. For this reason, we observed the relationship between fQRS wave and ventricular arrhythmia in the elderly after myocardial infarction. Methods 54 cases of senile myocardial infarction after conventional and dynamic electrocardiogram and clinical data were analyzed. According to the presence or absence of fQRS wave is divided into two groups, there are 29 cases of fQRS wave group; 25 cases without fQRS wave group. Follow-up of ICD-treated patients with discharge of fQRS-positive patients with ventricular arrhythmia was performed. Results The incidence of post-MI QRS wave in the elderly was 53.7% (29/54). The incidence of heart failure (9/29) in the fQRS group was significantly higher than that in the non-fQRS group (2/25) (31.1% vs 8.0%, P <0.05). 3 The incidence of ventricular arrhythmias in the fQRS group (13/29) was significantly higher than in the non-fQRS group (44/8 vs 16.0%, P <0.05). 4 In 8 patients with severe ventricular arrhythmias in the fQRS wave group and 5 patients with non-sustained ventricular tachycardia, ICDs were implanted, with several successful discharges at 6-18 months of follow-up. Conclusions The fQRS wave is closely related to the occurrence of ventricular arrhythmia after myocardial infarction. The fQRS wave has some value in the prediction of ventricular arrhythmia after myocardial infarction in the elderly.