まとめ
His bundle (H) blockを診断するには,慎重にカテーテル操作する必要があります. 初期記録は誤解を招くかもしれませんが,キャセターを引くとバンドルポテンシャルが明らかになり,心房内伝導障害の正確な診断に役立ちます.
科学分野:
- 電気生理学 電気生理学
- 心臓病学 心臓病学
背景:
- 動脈 (A-V) 伝導障害は一般的です.
- 正確な診断は,そのバンドルの潜在的記録の正確さに依存する.
- その束のポテンシャル (H と H') を同時に記録することは困難である.
研究 の 目的:
- 束の伝導障害の2つのケースを記述するために.
- カテーテル操作の重要性を彼のバンドル録音で強調するために.
- A-V伝導異常の診断精度を向上させるため.
主な方法:
- 10mmの電極間距離を持つ双極電極カテーテルを使用しました.
- A-V伝導の問題を抱えた2人の患者で,Hのバンドルポテンシャル (HとH') を観察した.
- バンドルポテンシャル記録を最適化するために,カテーテル位置 (引き出しと前進) を操作します.
- 彼の潜在的可視性を高めるために心房ペースを採用した.
主要な成果:
- プロキシマル (H) とディスタル (H') の両方の記録に失敗したため,彼の成分は当初,A-Vノダルブロックの誤診につながりました.
- 慎重にカテーテルを引いたところ,近辺ヒースポテンシャルが明らかになり,遠辺ポテンシャルが消失し,ヒースバンドルの損傷を示した.
- A 束の損傷と電極の空間的関係により,両方のコンポーネントを同時に記録することができなかった.
- Hisバンドル内のブラジカルディア依存性ブロックは,1人の患者で観察されました.
結論:
- カテーテルを外すことは,最初の記録が最適でないとき,His バンドルの病変を証明するために非常に重要です.
- 戦略的なキャセターの推移または撤去は,心房または心室複合体に対する潜在的なタイミングによって導かれ,診断を助けます.
- アトリアルペースは,近接ヒースポテンシャルの検出を向上させることができ,特にアトリアルコンプレックスによって遮られるときに役立ちます.
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Conduction System of the Heart
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