重新定义QRS过渡以确认左捆分支捕获在左捆分支区域步调期间
Sem Briongos-Figuero1, Álvaro Estévez Paniagua1, Ana Sánchez Hernández1
1Cardiology Department, Infanta Leonor Hospital, Madrid, Spain.
Frontiers in cardiovascular medicine
|July 31, 2023
概括
在螺合时使用QRS过渡的新方法可以帮助在LBB区域节奏 (LBBAP) 程序中确认左束枝 (LBB) 捕获. 这种技术显示了节奏V6-R波峰时间缩短至少10毫秒,在标准动态机动不足时提供了替代方案.
科学领域:
- 电子生理学 电子生理学
- 心脏节拍是因为心脏节拍.
- 干预心脏病学 干预心脏病学
背景情况:
- 左捆分支 (LBB) 捕获确认对于LBB区域节奏 (LBBAP) 是至关重要的.
- 在动态机动过程中标准的QRS过渡标准是有效的,但在不到50%的LBBAP程序中观察到.
- 需要使用替代方法来非侵入性确认LBB捕获.
研究的目的:
- 为了调查QRS过渡在穿透到间隔膜 (IVS) 期间是否可以表明LBB捕获.
- 为了评估中断的节律测绘在螺丝在确定LBB捕获期间的实用性.
- 为了比较心电图标准的左心室隔膜节拍 (LVSP) 和非选择性的LBB节拍 (ns-LBBP) 在进展期间.
主要方法:
- 定义QRS过渡为≥10毫秒缩短节奏V6-R波峰值时间 (RWPT) 从LVSP到ns-LBBP在螺合时.
- 在LVSP和ns-LBBP形态之间比较了心电图参数 (V6-RWPT,aVL-RWPT,V6-V1间隙间隔,LBBP得分).
- 分析了螺钉 (n=44) 与动态机动 (n=60) 期间的过渡.
主要成果:
- 在两组中,V6-RWPT的平均缩短时间相似 (17.3 ± 6.8 ms与18.8 ± 4.9 ms).
- 节奏V6-RWPT,aVL-RWPT,V6-V1间隙间,和LBBP得分在两组ns-LBBP中都是相似的.
- 标准V6-RWPT<75毫秒或V6-V1间隙>44毫秒在ns-LBBP中比较频繁,从螺钉 (70.5%) 与动态机动 (50%) 相比.
结论:
- 在深度IVS透过程中从LVSP到ns-LBBP的QRS过渡与中断的节律测绘可以表明LBB捕获.
- 节奏V6-RWPT缩短≥10毫秒作为LBB捕获的潜在标志物.
- 在动态机动不那么有信息时,螺钉提供了一个可行的替代方法来观察QRS过渡.
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