- 期刊
Effect of Short-term Cardiac Memory on Ventricular Electrical Restitution and QT Intervals in Humans
短時間心臟記憶對人心室電氣恢復曲線及QT長度的影響
摘要
心臟記憶現象會改變心室組織動作電位形狀及心室組織間的電位差。心臟記憶是否因改變心室組織動作電位形狀，進而引起心室性心律不整，目前並無詳細研究報告。本研究共包含20位陣發性上心室頻脈病人，於接受心電氣生理燒灼術後，測量QT長度，計算QT差異(QTd)，並且分別在600 ms及400 ms基礎刺激下，繪出心室電氣恢復曲線，並計算其曲線之最大斜率。以400 ms間隔，連續於右心室尖刺激20分鐘，誘發短暫心臟記憶後，馬上再度測量QT長度，計算QTd及心室電氣恢復曲線之最大斜率。比較心臟記憶誘發前後，QTc長度，QTd及心室電氣恢復曲線之最大斜率。結果發現心臟記憶誘發後，心室電氣恢復曲線之最大斜率及QTd並無明顯變化，然而，QTc長度明顯變短。由以上結果推論，心臟記憶對誘發心室性心律不整並無明顯影響。
並列摘要
Cardiac memory (CM) can alter the configuration of action potentials and the transmural repolarization gradient in ventricular tissue. This study evaluated the effects of CM on ventricular arrhythmogenicity. A total of 20 patients (12 females, 8 males; mean age, 46 ± 13 years) were enrolled. The following indicators were measured to evaluate ventricular arrhythmogenicity: (1) the action potential duration at 90% repolarization (APD90) recorded from the right ventricular apex (RVA); (2) the maximal slope of the action potential duration restitution curve (APDR) constructed by programmed extra stimuli from RVA; and (3) the maximal corrected QT interval (QTc) and QT interval dispersion (QTd). The short-term CM was induced by constant pacing from the RVAat a pacing cycle length (PCL) of 400 ms for 20 minutes. After induction of CM, the mean APD90 were significantly shortened at both PCLs of 600 ms and 400 ms (252.9±6.4 ms vs. 235.6±6.4 ms and 231.2±6.4 ms vs. 214.4±7.3 ms, respectively; p=0.001). No significant change regarding the maximal slopes of APDR were found at both PCLs of 600 ms and 400 ms (1.05±0.09 vs. 0.96±0.11 and 0.85±0.08 vs. 0.84±0.09, respectively). QTc (417.3±9.1 ms vs. 454.7±8.3 ms; p=0.001), but not QTd (63.4±5.4 ms vs. 65.7±6.1 ms), was significantly shortened. Short-term CM significantly decreased ventricular APD90 and QTc, but did not significantly change the maximal slope of APDR or QTd. These results suggest that CM might not have a significant effect on ventricular arrhythmogenicity.
延伸閱讀
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