心脏病学
医学
内科学
QRS波群
烧蚀
肥厚性心肌病
心电图
梗阻性心肌病
射频消融术
左心室肥大
心肌病
振幅
室性心动过速
导管消融
左束支阻滞
射血分数
心力衰竭
血压
光学
物理
量子力学
作者
Lei Zuo,David H. Hsi,Li Zhang,Qin Zhang,Shao Hong,Bing Liu,Changhui Lei,Chuang Ye,Xin Meng,Guoqing Zhang,Mengyao Zhou,Jing Li,Yang He,Jian-Ying Guo,Liwen Liu
标识
DOI:10.1016/j.jelectrocard.2020.06.013
摘要
Abstract Objectives This study aimed to determine whether the serial changes of the electrocardiogram is associated with regression of left ventricular hypertrophy (LVH) after Liwen procedure. Background Clinical application of the echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation (PIMSRA, Liwen procedure) is an innovative approach to treat hypertrophic obstructive cardiomyopathy (HOCM). Methods We enrolled 30 consecutive patients with HOCM who had undergone Liwen procedure in our Hypertrophic Cardiomyopathy Center, from June 2016 to January 2018. Electrocardiography (ECG) and echocardiogram were performed before and after Liwen procedure, and at each follow-up (1-week, 1, 3, 6 months and 1 year). The Sokolow–Lyon index (SLi), Q wave, R wave, S wave amplitude of 12-lead ECG and interventricular septal (IVS) thickness, left ventricular mass index (LVMI) by echocardiograms were measured in each patient. The sum of the ECG QRS amplitude on each lead was calculated. The reduction of SLi and QRS amplitude were used as improvement index. Results The ECG leads with most improvement rate of the QRS wave amplitude of all cases were V1 and V2, both at 90%. The QRS wave amplitude in V1 leads and SLi were positively correlated with IVS thickness and LVMI at baseline and 1 year after Liwen procedure, respectively. The reduction of IVS thickness, LVMI and QRS wave amplitude in leads V1 and V2 were significant at one month after ablation and the follow-up period. SLi was significantly decreased at 3 months during the observation period. Similarly, the improvement of ECG QRS wave amplitude after the Liwen procedure tracked the gradual thinning of the IVS and the changes of SLi reflected the regression of LVH. Conclusion The QRS wave amplitude reductions in lead V1 and SLi may be good indicators for evaluating the postoperative interventricular septal remodeling of the Liwen procedure.
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