イントラカルディアック電図T波の変数/変数増加は,インプラント可能な心変容器-除細動器患者における自発的な心室性タキアリズムに先立ちます:前向きな多センター研究
Charles Swerdlow1, Theodore Chow, Mithilesh Das
1Cedars-Sinai Medical Towers, 8635 W Third St, Ste 1190-W, Los Angeles, CA 90048. swerdlow@ucla.edu.
Circulation
|March 2, 2011
まとめ
埋め込み可能な心変容器-除細動器の電図から測定されたT波変数 (TWA/V) は,心室動脈不全/動 (VT/VF) の発生前に著しく高くなっています. この発見は,TWA/Vが,迫り来るVT/VFに対する重要な警告信号として機能することを示唆しています.
科学分野:
- 心臓病学 心臓病学
- バイオメディカルエンジニアリング
背景:
- T-wave alternans (TWA) は,心室動脈不全 (VT) と動 (VF) の前駆体として知られています.
- 新しく開発された方法では,埋め込み心筋回転器-除細動器 (ICD) 電図 (EGM) からTWAおよび非代替性 (TWA/V) の変動性を測定しています.
研究 の 目的:
- ベースラインと比較して,ICD患者のVT/VFエピソード前にEGM TWA/Vが上昇しているかどうかを前向きに評価する.
- VT/VFイベントに対するEGM TWA/Vの予測価値を評価する.
主な方法:
- 63人のICD患者を対象とした多センター研究.
- TWA/Vは,自発的なVT/VFと様々なコントロール記録 (ベースライン,ペース,ホルター,SVT) 前に保存されたEGMから計算される.
- TWA/VとVT/VFの確率との関連を判断するために使用されるロジスティック回帰.
主要な成果:
- 追跡期間中に28人の患者で合計166回のVT/VFエピソードが発生しました.
- EGM TWA/VはVT/VF前 (62.9 ± 3.1 μV) において,すべての対照条件 (P < 0.0001) よりも著しく高かった.
- TWA/Vの10μV増加は,VT/VFの確率の2.2倍増加と相関していた (P < 0.0001).
結論:
- EGM TWA/Vは,ICD患者における自発的なVT/VFに先立つ強力な指標である.
- 将来のICDでEGM TWA/Vの継続的なモニタリングは,VT/VFの早期警告と予防的なペースセラピーを可能にすることができます.
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