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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >QT interval dispersion in ventricular beats: a noninvasive marker of susceptibility to sustained ventricular arrhythmias.
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QT interval dispersion in ventricular beats: a noninvasive marker of susceptibility to sustained ventricular arrhythmias.

机译：QT间隔在心室搏动中的分散：持续性心律失常易感性的非侵入性标志物。

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Increased QT dispersion (QTd) calculated from sinus beats has been shown to identify patients prone to sustained VT. However, predictive accuracy of this parameter is limited. Electrophysiological properties of the myocardium may be altered by a premature ventricular beats, which is a well-established trigger for sustained VT. Therefore, the author hypothesised that QTd in spontaneous or paced ventricular beats may improve identification of patients with inducible sustained VT. In 28 consecutive patients (men, mean age 61 +/- 13 years) who underwent programmed ventricular stimulation, the values of QTd calculated in sinus and ventricular beats were compared between inducible and noninducible patients. The mean QTd values obtained using three different methods differed significantly, QTd in paced ventricular beats being the highest, QTd in spontaneous ventricular beats was intermediate, and QTd in sinus beats was the lowest (83.9 +/- 30 vs 63.0 +/- 29 ms vs 53.9 +/- 27 ms, P < 0.0001 and P < 0.004, respectively). In 13 (46%) patients sustained VT was induced. QTd values were significantly higher in inducible than noninducible patients (QTd sinus beats: 67.5 +/- 31 vs 42.1 +/- 11 ms, P = 0.02; QTd spontaneous ventricular beats: 79.3 +/- 35 vs 46.7 +/- 13 ms, P = 0.008, and QTd-paced ventricular beats: 104.8 +/- 32 vs 65.9 +/- 9 ms, P = 0.0009). The receiver operator characteristic curves showed that at a sensitivity level of 100%, the highest specificity for identification of inducible patients had QTd measured in paced ventricular beats (87%) followed by QTd in spontaneous ventricular beats (45%), and QTd in sinus beats (40%). In conclusion, (1) QTd in ventricular beats is greater than in sinus beats, and (2) QTd calculated from paced ventricular beats identifies patients with inducible sustained VT better than QTd measured during sinus rhythm.
机译：由窦性心律计算得出的增加的QT离散度（QTd）已显示出可识别出易于持续VT的患者。但是，此参数的预测准确性受到限制。早搏性心室搏动可能会改变心肌的电生理特性，这是持续性VT的公认触发因素。因此，作者假设，自发性或节律性心律失常中的QTd可能会改善对诱导型持续性VT患者的识别。在连续28例接受程序性心室刺激的患者（男性，平均年龄61 +/- 13岁）中，比较了诱导型和非诱导型患者在窦性心律和心室搏动中计算的QTd值。使用三种不同方法获得的平均QTd值差异显着，在步速性心搏中的QTd最高，在自发性心律中的QTd中等，而在窦性心律中的QTd最低（83.9 +/- 30 vs 63.0 +/- 29 ms vs 53.9 +/- 27毫秒，分别为P <0.0001和P <0.004）。在13名（46％）患者中诱发了持续性VT。诱导型患者的QTd值显着高于非诱导型患者（QTd窦性心搏：67.5 +/- 31 vs 42.1 +/- 11 ms，P = 0.02; QTd自发性心室搏动：79.3 +/- 35 vs 46.7 +/- 13 ms， P = 0.008，QTd起搏心室搏动：104.8 +/- 32 vs 65.9 +/- 9 ms，P = 0.0009）。接收者操作员特征曲线显示，在灵敏度水平为100％时，识别可诱导患者的最高特异性是在心律不齐的心律起搏中测得的QTd（87％），在自发性心律失常中测得的QTd（45％），在窦性心律中测得的QTd跳动（40％）。总之，（1）心室搏动中的QTd大于窦性心律，（2）根据心律起搏计算出的QTd可以确定，诱导性持续性VT优于在窦性心律期间测得的QTd。

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