徐博, 刘金成, 易蔚, 刘丽文, 孟欣, 李静, 雷常慧, 周梦垚, 朱晓丽, 薛武超, 左蕾. 梗阻性肥厚型心肌病经皮心肌内室间隔射频消融术(Liwen术式)后心电图QRS波振幅的变化[J]. 心脏杂志, 2020, 32(6): 582-586. DOI: 10.12125/j.chj.202008081
    引用本文: 徐博, 刘金成, 易蔚, 刘丽文, 孟欣, 李静, 雷常慧, 周梦垚, 朱晓丽, 薛武超, 左蕾. 梗阻性肥厚型心肌病经皮心肌内室间隔射频消融术(Liwen术式)后心电图QRS波振幅的变化[J]. 心脏杂志, 2020, 32(6): 582-586. DOI: 10.12125/j.chj.202008081
    Bo XU, Jin-cheng LIU, Wei YI, Li-weng LIU, Xin MENG, Jing LI, Chang-hui LEI, Meng-yao ZHOU, Xiao-li ZHU, Wu-chao XUE, Lei ZUO. Reduction of QRS amplitude on ECG by echocardiogmphy-guided percutaneous intramyocardial radiofrequency ablation (Liwen Procedure) in patients with hypertrophic obstructive cardiomyopathy[J]. Chinese Heart Journal, 2020, 32(6): 582-586. DOI: 10.12125/j.chj.202008081
    Citation: Bo XU, Jin-cheng LIU, Wei YI, Li-weng LIU, Xin MENG, Jing LI, Chang-hui LEI, Meng-yao ZHOU, Xiao-li ZHU, Wu-chao XUE, Lei ZUO. Reduction of QRS amplitude on ECG by echocardiogmphy-guided percutaneous intramyocardial radiofrequency ablation (Liwen Procedure) in patients with hypertrophic obstructive cardiomyopathy[J]. Chinese Heart Journal, 2020, 32(6): 582-586. DOI: 10.12125/j.chj.202008081

    梗阻性肥厚型心肌病经皮心肌内室间隔射频消融术(Liwen术式)后心电图QRS波振幅的变化

    Reduction of QRS amplitude on ECG by echocardiogmphy-guided percutaneous intramyocardial radiofrequency ablation (Liwen Procedure) in patients with hypertrophic obstructive cardiomyopathy

    • 摘要:
        目的  超声心动图引导下经皮心肌内室间隔射频消融术(Liwen术式)是治疗梗阻性肥厚型心肌病(HOCM)的一种创新方法。HOCM最常见的心电图改变是QRS波振幅增高。我们假设采用Liwen术式导致室间隔肥厚部位的变薄从而引起心电图(ECG)QRS波振幅的降低。
        方法  从2016年6月至2017年6月,连续纳入肥厚型心肌病中心20例经过Liwen术式治疗的HOCM患者。术前以及术后每次随访(1周,1、2、3、6、12个月)均行心电图和超声心动图检查。采用心电图测量12导联心电图Q波、R波、S波振幅,超声心动图测量室间隔厚度(IVS)。计算心电图每个导联的QRS波振幅之和。QRS波振幅降低作为改善指标。
        结果  在Liwen术式治疗后心电图QRS波振幅改善率最高的导联为V1和V2导联,分别为90%和85%。术前V1、V2导联的QRS波振幅与前室间隔厚度呈正相关,术后V1、V2导联QRS波振幅在随访期间明显降低。心电图QRS波振幅的改善可以反映术后IVS的逐渐变薄。
        结论  心电图V1、V2导联的QRS波振幅降低可作为评价Liwen术式治疗HOCM室间隔变薄的指标之一。

       

      Abstract:
        AIM   To verify our hypothesis that abolishing the hypertrophic myocardial mass in the septal region of the left ventricle by Liwen Procedure may result in a reduction of QRS amplitude on the electrocardiogram (ECG).
        METHODS  We enrolled 20 consecutive patients with hypertrophic obstructive cardiomyopathy (HOCM) who had undergone Liwen procedure in our Hypertrophic Cardiomyopathy Center from June 2016 to June 2017. ECG and echocardiogram were performed before and after Liwen Procedure and at each follow-up (1-week, 1, 2, 3, 6 months and 1 year). The Q wave, R wave and S wave amplitude of 12-lead ECG and interventricular septal thickness (IVS) by echocardiograms were measured in each patient. The sum of the ECG QRS amplitude on each lead was calculated. The QRS amplitude reduction was used as an improvement index.
        RESULTS  Our results showed that the leads with most improvement rate of the ECG QRS total amplitude in all the cases were V1 and V2, respectively at 90% and 85%. The QRS amplitude at baseline in V1 and V2 leads were positively correlated with anterior IVS thickness. In V1 and V2 leads, the reduction of QRS amplitude was significant after the operation. Similarly, the improvement of ECG QRS amplitude after the Liwen procedure tracked the gradual thinning of the IVS.
        CONCLUSION  The ECG QRS amplitude reduction in leads V1 and V2 may be one of the indicators for evaluating the postoperative interventricular septal reduction of the Liwen procedure.

       

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