リエントラント心室動脈性タキカルディアの際に,遅い伝導領域の位置づけ
1Departments of Pharmacology and Biomedical Engineering, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. ciaccio@columbia.edu
Circulation
|July 25, 2000
まとめ
新しい方法であるパーツバイズ・リニア・アダプティブ・テンプレート・マッチング (PLATM) は,電図のシフトを用いて,心室性短動脈における遅い伝導ゾーン (SCZ) を特定する. このテクニックは,探査機をSCZに誘導することによって,より正確なカテーテルアブレーションに役立ちます.
科学分野:
- 心血管電気生理学 心血管電気生理学
- 医療機器技術 医療機器技術について
背景:
- リエントラント静脈性心拍動脈 (VT) の治療は,遅い伝導ゾーン (SCZ) の局所化が困難であるため,困難です.
- SCZの正確な局所化は,効果的なカテーテルアブレーション療法にとって極めて重要です.
研究 の 目的:
- SCZの位置は,波長の加速/減速と遠域電図信号の変化の関係を解析することによって近似することができるという仮説を検証する.
- 静脈管切除の結果を改善するために,SCZの局所化のための新しい方法を開発する.
主な方法:
- アクティベーション時間間隔と遠場電図シフトに基づいてSCZの位置を近似するために,ピースバイズ線形適応テンプレートマッチング (PLATM) を使用したモデルを開発しました.
- VT再入場中に犬のモデルで表心部位から記録された電図.
- 波長線の速度を判定するためのアクティベーションマップを構築し,遠場偏移における時間シフトを測定するためにPLATMを使用しました.
主要な成果:
- リエントリー中の心拍回路長さの変化の線形傾向が実証された.
- SCZ経由での活性化までの時間間隔が,心拍回路長さの変化と良好に相関していることを示した.
- PLATMは,記録サイトのアクティベーションからSCZのエッジまでの時間を正確に予測し,アクティベーションマッピングと比較して平均絶対誤差は20.3msでした.
結論:
- PLATMは,回路付近の記録場所から,再入力の際にSCZの活性化までの間隔を効果的に推定します.
- PLATMから派生した時間間隔は,弧長に変換することができ,潜在的にSCZに向かって,より速く,より正確にアブレーションプローブを誘導することができます.
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