Tehran University Medical Journal
مجله دانشکده پزشکی، دانشگاه علوم پزشکی تهران
Tehran Univ Med J
Medical Sciences
http://tumj.tums.ac.ir
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1683-1764
1735-7322
10.18869/acadpub.tumj
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fa
jalali
1390
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2011
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online
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یافتههای الکتروکاردیوگرام در تاکیکاردی بطنی با منشا خروجی بطن راست و بطن چپ
The electrocardiogram findings in patients with LVOT and RVOT ventricular tachycardia
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<p dir="rtl" style="text-align: justify direction: rtl unicode-bidi: embed" class="MsoNormal"><strong><span style="font-size: 10pt">زمینه و هدف</span></strong><span style="font-size: 10pt">:</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt">افتراق منشا تاکیکاردی
بطنی با استفاده از الکتروکاردیوگرام دید بهتری نسبت به تشخیص این بیماران قبل از
انجام پروسههای تهاجمیتر میدهد. مطالعه حاضر جهت مقایسه یافتههای
الکتروکاردیوگرام در </span><span style="font-size: 10pt">بیماران مبتلا به تاکیکاردیهای</span><span style="font-size: 10pt"> بطنی از منشا خروجی
بطن چپ و بطن راست صورت </span><span style="font-size: 10pt">گرفته</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt">است</span><span style="font-size: 10pt">. </span><strong><span style="font-size: 10pt"><br></span></strong></p><p dir="rtl" style="text-align: justify direction: rtl unicode-bidi: embed" class="MsoNormal"><strong><span style="font-size: 10pt">روش
بررسی:</span><em><span style="font-size: 10pt"> </span></em></strong><span style="font-size: 10pt">در این </span><span style="font-size: 10pt">مطالعه بررسی مقطعی، بیمارانی که با تشخیص تاکیکاردی
بطنی با منشا خروجی بطن چپ و راست طی دو سال جهت</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt">انجام سوزاندن
با کاتتر</span><span style="font-size: 10pt"> در </span><span style="font-size: 10pt">بیمارستان</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt">شهید رجایی پذیرش شده بودند، وارد
مطالعه شدند و شیوع دو آریتمی فوق و نتایج نوار قلب و</span><span style="font-size: 10pt"> میزان موفقیت</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt">سوزاندن با کاتتر</span><span style="font-size: 10pt"> در درمان دو نوع آریتمی ذکر شده در بیماران با
منشا خروجی بطن چپ و راست مقایسه گردید. <br></span></p><p dir="rtl" style="text-align: justify direction: rtl unicode-bidi: embed" class="MsoNormal"><span style="font-size: 10pt"></span><strong><span style="font-size: 10pt">یافتهها:</span></strong><span style="font-size: 10pt"> در بررسی 59 بیمار که
1/44% </span><span style="font-size: 10pt">مذکر</span><span style="font-size: 10pt"> و 9/55% مونث </span><span style="font-size: 10pt">بودند</span><span style="font-size: 10pt">، میانگین </span><span style="font-size: 10pt">سنی</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt">بیماران</span><span style="font-size: 10pt"> (76/13</span><span style="font-size: 7pt">=</span><span style="font-size: 7pt">SD</span><span style="font-size: 10pt">) 67/41 سال بود. در مقایسه </span><span style="font-size: 7pt">QRS</span><span style="font-size: 10pt"> </span><span style="font-size: 8pt">transition</span><span style="font-size: 10pt"> <span lang="AR-SA">و </span></span><span style="font-size: 10pt">شکاف
تفاوت معنیداری میان دو گروه وجود</span><span style="font-size: 10pt"> داشت (007/0</span><span style="font-size: 7pt">P=</span><span style="font-size: 10pt">، 027/0</span><span style="font-size: 7pt">P=</span><span style="font-size: 10pt">)</span><span style="font-size: 10pt">.</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt">در
مقایسه مدت</span><span style="font-size: 7pt">R</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt"><span> </span>به </span><span style="font-size: 7pt">QRS</span><span style="font-size: 10pt"> در </span><span style="font-size: 10pt">لیدهای</span><span style="font-size: 10pt"> پرهکوردیال، در
بیماران </span><span style="font-size: 10pt">با تاکیکاردی با </span><span style="font-size: 10pt">منشا خروجی بطن راست، (16/0</span><span style="font-size: 7pt">=</span><span style="font-size: 7pt">SD</span><span style="font-size: 10pt">) 69/0 و در </span><span style="font-size: 10pt">بیماران با منشا
خروجی بطن</span><span style="font-size: 10pt"> چپ، (06/0=</span><span style="font-size: 7pt">SD</span><span style="font-size: 10pt">) 81/0 بود (015/0</span><span style="font-size: 7pt">P=</span><span style="font-size: 10pt">)</span><span style="font-size: 10pt">. </span><span style="font-size: 10pt">همچنین</span><span style="font-size: 10pt"> </span><span style="font-size: 8pt">ablation</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt">موفقیتآمیز </span><span style="font-size: 10pt">در 30 </span><span style="font-size: 10pt">بیمار</span><span style="font-size: 10pt"> (2/</span><span style="font-size: 10pt">73</span><span style="font-size: 10pt">%) با تاکیکاردی با منشا </span><span style="font-size: 10pt">خروجی</span><span style="font-size: 10pt"> بطن راست، در مقابل 14 </span><span style="font-size: 10pt">بیمار</span><span style="font-size: 10pt"> (3/93%) منشا خروجی بطن چپ صورت گرفت که تفاوت
معنیدار نبود. <br></span></p><p dir="rtl" style="text-align: justify direction: rtl unicode-bidi: embed" class="MsoNormal"><span style="font-size: 10pt"></span><strong><span style="font-size: 10pt">نتیجهگیری:</span></strong><span style="font-size: 10pt"> </span><span style="font-size: 10pt">طبق</span><span style="font-size: 10pt"> نتایج مطالعه </span><span style="font-size: 10pt">حاضر</span><span style="font-size: 10pt">، موفقیت </span><span style="font-size: 10pt">درمانی</span><span style="font-size: 10pt"> رادیو </span><span style="font-size: 10pt">فرکوئنسی
سوزاندن با ک</span><span style="font-size: 10pt">اتتر
در بیماران با </span><span style="font-size: 10pt">تاکیکاردیهای</span><span style="font-size: 10pt"> بطنی با منشا خروجی </span><span style="font-size: 10pt">بطن</span><span style="font-size: 10pt"> چپ و راست بالا بوده
و میان آنها از نظر </span><span style="font-size: 10pt">شکاف</span><span style="font-size: 10pt">، </span><span style="font-size: 7pt">QRS</span><span style="font-size: 10pt"> </span><span style="font-size: 8pt">transition</span><span style="font-size: 8pt"> </span><span style="font-size: 10pt">و نسبت طول </span><span style="font-size: 10pt">مدت</span><span style="font-size: 7pt">R</span><span style="font-size: 10pt"> </span><span style="font-size: 10pt"><span> </span>به </span><span style="font-size: 7pt">QRS</span><span style="font-size: 10pt"> تفاوت وجود </span><span style="font-size: 10pt">داشته</span><span style="font-size: 10pt"> که </span><span style="font-size: 10pt">میتواند</span><span style="font-size: 10pt"> به عنوان عاملی جهت
افتراق آنها استفاده شود.</span></p>
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<!--stripped--> <strong>Background</strong><strong>:</strong> Distinguishing the origin of ventricular tachycardia (VT) by electrocardiogram (ECG) which is performed in all
patients, helps to diagnose the cause of VT before trying invasive procedures. The aim of this study was to
compare the ECG findings in patients with VT originating from Right or Left Ventricular Outflow Tracts (RVOT or LVOT). <br><strong>Methods</strong> <strong>:</strong> Fifty nine patients with VT originating from LVOT or RVOT were selected for this cross-sectional study. The patients were
recruited while they were attending Shahid Rajaei Hospital in Tehran, Iran in 2009-2010 for catheter ablation.
The participants were evaluated for the prevalence of LVOT and RVOT and were compared for the success
rate of radiofrequency catheter ablation. <br><strong>Results</strong> <strong>:</strong> Out of 59 patients, 44.1% were male and 55.9% were female. The mean age of the participants was 41.67 (SD=13.76) years. QRS transition and notch in ECGs were significantly different
(respectively, P=0.027 and P=0.007) between patients with LVOT and RVOT. R-to-QRS duration in precordial leads was significantly longer in patients
with LVOT than
those with RVOT [0.81 (SD=0.06) ms vs. 0.69 (SD=0.16), P=0.015]. Successful ablation was performed in 73.2% of patients with RVOT versus 93.3% of those with LVOT, but despite a higher rate the
differences were not statistically significant (P=0.215). <br><strong>Conclusion:</strong> In this study, RF catheter ablation was
successful like other studies on patients with ventricular tachycardia and RVOT VT and LVOT VT had significant differences
in notch, QRS transition and R-to-QRS duration in precordial leads which are important in differentiating
between the two conditions.</p>
رادیوفرکوئنسی سوزاندن با کاتتر،LVOT،RVOT
Left ventricular outflow tract,radiofrequency catheter ablation,right ventricular outflow tract
467
474
http://tumj.tums.ac.ir/browse.php?a_code=A-10-25-202&slc_lang=fa&sid=1
Farsavian
AA
علیاصغر
فرسویان