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鼻波面激活和心室外刺激映射与心室高心率重入电路的关联

Jonathan Chrispin¹, Harikrishna Tandri²

¹Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

JACC. Clinical electrophysiology

|July 22, 2023

概括

在切除过程中使用减小步调和S2映射绘制腹腔动脉节拍 (VT) 脉络的映射比鼻腔节律映射更准确. 这种改进的准确性有助于基质基底切除,特别是当静脉动诱导不理想时.

科学领域:

心血管电生理学心血管电生理学
心脏切除技术心脏切除技术
节律失常映射节律失常映射

背景情况:

腹腔动脉冲动 (VT) 的基质基底切除依赖于使用延迟和分离电图来识别静脉冲动脉峡.
鼻腔节律映射受到激活波面方向和下降节奏的影响,可能会影响VT脉识别.

研究的目的:

为了将不同波面映射和下降节奏与关键的VT地峡部位相关联,在各种波面映射和下降节奏期间最新激活的区域.
为了评估不同的绘图策略在识别VT峡谷的切除时的有效性.

主要方法:

在20名接受单态静脉管切除的患者中创建了高密度的电解剖学基质图.
映射了鼻节奏,右心室 (RV) 角节奏和RV角S2节奏 (20毫米以上有效耐火期).
将最新的激活地点与传统识别的VT峡谷进行了比较.

主要成果:

最新的激活与静脉脉的一致性在鼻节律中为75%,在RV垂节奏中为85%.
在95%的病例中,S2刺激后最近一次激活的部位与静脉管道支柱相结合.
该研究包括患有结构性心脏病的患者,主要是缺血性心脏病 (50%) 和心律失常性RV心肌病 (35%).

结论:

在减速节奏过程中导电减速的区域,特别是S2映射,比起鼻腔节律映射更准确地识别VT峡.
这些发现表明,在基质VT切除中,减小步调和S2映射具有宝贵的作用,特别是当VT诱导不可行或不理想时.

关键词:

渐变的节奏是下降的.这里是胸.腹腔动脉短心症是什么意思

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