剩余单极电压和心律失常的复发之间的关联在左心房后壁隔离后,用于持续性心房动
Hirofumi Kujiraoka1, Rintaro Hojo1, Tomoyuki Arai1
1Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
Journal of cardiovascular electrophysiology
|July 2, 2023
概括
对于持续性心房动 (AF) 进行切除后,后壁的残余单极潜力预测心律失常的复发. 识别这些潜力可以改善患者的治疗结果,并指导进一步的AF管理治疗策略.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗成像医学成像
背景情况:
- 后壁隔离 (PWI) 与肺静脉隔离 (PVI) 结合,是一种治疗持续性心房的策略.
- 在PWI期间实现跨线性病变可能具有挑战性,可能导致残留的可活性心肌.
- 内心单极电压映射显示了更高的灵敏度比双极映射检测室内心脏组织.
研究的目的:
- 调查PWI后后壁的残余单极潜力与持续性AF患者中心房律乱的复发之间的相关性.
- 评估内心单极电压的预测值,以识别废除后的残余电活动.
主要方法:
- 一个单一中心的观察性研究包括109名接受PVI和PWI治疗的患者.
- 患者的分类是基于残余单极后壁潜力的存在 (≥1.08mV) 或不存在.
- 在两组之间比较了心房律乱的复发率.
主要成果:
- 43名患者 (39.4%) 具有残留单极潜力,而66名 (60.6%) 没有.
- 与没有 (17.9%;p=0.003) 相比,心房律乱的复发率在残留潜能组 (41.8%) 中明显高于没有 (17.9%;p=0.003).
- 剩余单极潜力被确定为复发的独立预测因子 (OR 4.53; 95% CI 1.67-12.3; p=0.003).
结论:
- 对于持久性AF,PWI后后背壁的残余单极潜力与复发性心房律乱有显著的关联.
- 内心单极电压映射可以识别PWI后AF复发风险较高的患者.
- 这些发现表明,优化PWI以消除残留潜力可能是改善长期成功率的关键.
更多相关视频
08:10Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
1.7K
05:43Author Spotlight: Improving Lesion Contiguity in Pulmonary Vein Isolation via Proactive Esophageal Cooling
Published on: April 19, 2024
1.1K
相关概念视频
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
49
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...
49
01:28Disturbances in Heart Rhythm
1.0K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
1.0K
01:18Dysrhythmias IV: Characteristics of Bradyarrhythmias
12
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
12
01:28Mechanism of Cardiac Arrhythmias
965
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
965
01:30Dysrhythmias V: Evaluating Dysrhythmias
42
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
42
01:30Cardiac Action Potential
1.7K
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
1.7K