与不均匀复极相关的qt延长使心脏对心律失常的易感性增加:与长qt综合征相关的心律失常病理机制的进一步数据。

F Solti, E Czakó, S Juhász-Nagy, V Kékesi, A Szántó, P Oswald
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引用次数: 0

摘要

心律失常连续延长电性收缩期的病理机制-长QT综合征-在心脏局部低温研究。用冷却的血液灌注右冠状动脉中段和末端,在右心室的限定区域诱导QT间期(长QT间期和不均匀复极)的局部增加。应用程序电刺激法研究QT局部延长对心脏心律失常易感性的影响。心脏局部低温诱导增加心电图示踪的QT间期,如果QT已校正心率也是如此。局部心电示图显示,在诱导性低温作用下,选定右心室区域的QT间期明显增加,但相对于QT (ERP/QT)则减少。与非均匀复极相关的长QT与心脏的易怒增加密切相关。发现早期心室冲动可引起心动过速、室性心动过速或心室颤动。结果表明,导致长qt综合征的速性心律失常的原因可能一方面归因于复极的不均匀性,另一方面归因于ERP相对于qt持续时间的短。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Increased susceptibility of the heart to arrhythmia in response to QT-prolongation associated with unhomogeneous repolarization: further data concerning the pathomechanism of arrhythmias associated with long QT-syndrome.

The pathomechanism of arrhythmias consecutive to a prolonged electrical systole --the long QT syndrome--was studied by local hypothermia in the heart. Local increase in the QT-interval (long QT with unhomogeneous repolarisation) was induced at a circumscribed area of the right ventricle by perfusion of the mid- and end-sections of the right coronary with cooled blood. The effect of local prolongation of QT on the arrhythmic susceptibility of the heart was studied by means of programmed electrical stimulation. Induced local hypothermia of the heart was found to increase the QT-interval of the ECG-tracings, also if QT had been corrected for heart rate. The local ECG tracings showed a considerable increase of the QT-interval at the selected right ventricular area under the effect of induced hypothermia but in relation to QT (ERP/QT) it diminished. The long QT in association with an unhomogeneous repolarization went hand in hand with an increased irritability of the heart. Early ventricular impulses were found to elicit extrasystolic runs, ventricular tachycardia or ventricular fibrillation. The results indicate that the cause of tachyarrhythmias consecutive to the long QT-syndrome may be ascribed to the inhomogeneity of repolarization on the one hand, and to the shortness of ERP in relation to the QT-duration on the other.

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