Abstract：Objective To investigate the dynamic change of microvolt T-wave electrical alternation(MTWA) in acute myocardial infarction(AMI) during different reperfusion periods and its correlation with ventricular arrhythmia after reperfusion. MethodsOne hundred and two AMI patients were divided into ventricular tachycardia(VT) group and nonVT group after percutaneous coronary intervention(PCI), and the clinical data and ECG parameters of the two groups were compared and analyzed. ResultsFortyseven among the 102 patients had VT and 55 had no VT. The average ventricular rate, hypersensitive troponin, MTWA and turbulence onset(TO) in VT group were significantly higher than those in the non-VT group, while turbulence slope(TS) and EF were significantly lower than those in the nonVT group（P＜0.05）. The results showed that there is no significant difference in SDNN between the two groups. MTWA had the highest sensitivity, specificity, positive predictive value and negative predictive value in predicting VT. The MTWA value of (82.9±10.2)μV appeared at 15 minutes before the appearing of the longest string of VT, which was significantly higher than that of 30 minutes and 60 minutes（P＜0.05）. Most of the time nodes of VT occurred in 1-3 hours after the blood flow recanalization. ConclusionsMTWA can predict the occurrence of reperfusion malignant VT in AMI patients after PCI, and the incidence of VT is the highest in 1-3 hours after blood flow recanalization. For MTWA positive patients during this period and before PCI, antiarrhythmic drugs such as amiodarone should be applied to prevent the occurrence of malignant VT, increase the postoperative survival rate of patients, and prevent sudden death.
熊望琼,汪自龙. 微伏级T波电交替在急性心肌梗死不同再灌注时间中的临床意义[J]. 实用心电学杂志, 2020, 29(1): 8-12.
Xiong Wangqiong, Wang Zilong. Clinical significance of microvolt T-wave alternans during different reperfusion periods in acute myocardial infarction. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2020, 29(1): 8-12.
