まとめ
この研究は,心筋梗塞の内臓表面の近くから発症する缺血性心臓病における心室性短心症を示しています. エピカルディアのマッピングだけでは,これらの心室性タヒカルディアの起源を正確に特定するには不十分です.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心臓外科手術について
背景:
- 再発性心室性低心力症 (VT) は,冠動脈疾患 (CAD) と心筋梗塞 (MI) の患者の重要な合併症です.
- VTの起源を正確に特定することは,しばしば外科的介入を含む効果的な治療に不可欠です.
研究 の 目的:
- 心臓発作性心疾患の患者でVT中に心室活性化の正確な起源を調査する.
- VT基質を特定するために,副心筋マッピングと,副心筋と内心筋マッピングを組み合わせたマッピングの十分性を評価する.
主な方法:
- 21人のCADと以前のMIを患った患者で,再発性VTの手術を受けた 21人の患者で,手術中の上心臓と内心臓のマッピングが行われました.
- Ventricular tachycardias (29の異なる形態) を誘導し,広範な電図記録 (55-75の表心,28-55の内心部位) を使用してマッピングしました.
- マッピングデータは,ECGとレファレンス電図とともに分析され,最も初期の活性化部位を決定しました.
主要な成果:
- 早期の心室活性化は,マッピングされたすべての心拍動脈において,一貫して,心臓発作領域の内臓表面で発生した.
- QRS複合体の発生に先行した内心電気活動は,その起源を示しています.
- 最早の表心臓活性化が遅れた (10msec QRS後),表心臓突破は両心室で発生した.
結論:
- 発血性心疾患における心室性短心症は,心臓発作の境界に隣接する左心室の内臓表面から発生します.
- エピカルディアのマッピングだけでは,これらのVT基板の起源を正確に定位するには不十分です.
- この患者集団におけるVT起源の正確な識別のために,内心臓と上心臓の組み合わせたマッピングは不可欠です.
さらに関連する動画
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
06:40Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System
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関連する概念動画
01:13The Cardiac Cycle
The heart beats rhythmically in a sequence called the cardiac cycle—a rapid coordination of contraction (systole) and relaxation (diastole).
The Process
Electrical signals—sent from the sinoatrial (SA) node in the right atrial wall to the atrioventricular (AV) node between the right atrium and right ventricle—cause both atria to simultaneously contract. When the signal reaches the AV node, it pauses for approximately a tenth of a second, allowing the atria to contract and empty blood into the...
The Process
Electrical signals—sent from the sinoatrial (SA) node in the right atrial wall to the atrioventricular (AV) node between the right atrium and right ventricle—cause both atria to simultaneously contract. When the signal reaches the AV node, it pauses for approximately a tenth of a second, allowing the atria to contract and empty blood into the...
01:19Electrophysiology of Normal Cardiac Rhythm
The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase of...
01:25Correlation between ECG and Cardiac Cycle
The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:30Cardiac Action Potential
Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
01:29Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...