与步调QRS复合体相比,非侵入式电气映射用于优化CRT编程设置和预测多维响应
Frances L Morales1, Derek J Bivona1, Mohamad Abdi1
1University of Virginia Health System, Charlottesville, VA, 22901, USA.
Journal of cardiovascular translational research
|September 6, 2023
概括
身体表面电图准确地预测心脏再同步治疗 (CRT) 的成功. 这种3D绘图方法可以确定最佳节奏策略,从而改善CRT治疗患者的心脏功能和结果.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 电子生理学 电子生理学
背景情况:
- 心脏再同步治疗 (CRT) 是心力衰竭的关键治疗方法.
- 优化CRT节奏策略仍然是一个挑战.
- 预测患者对CRT的反应对于改善结果至关重要.
研究的目的:
- 评估身体表面电图是否可以确定最佳的CRT节奏策略.
- 为了确定电气映射是否预测CRT结果.
- 评估电气激活时间和心脏功能之间的相关性.
主要方法:
- 在30名患者身上使用252个电极背心 (CardioInsight) 进行身体表面电图绘制.
- 定义的左心室 (LV),右心室 (RV) 和双心室 (BIV) 电激活时间 (LV80,RV80,BIV80).
- 与CRT后的心脏功能,心肌氧吸收和B型尿素 (BNP) 水平相关联的电映射参数.
主要成果:
- 在LV80和RV80中较小的差异 (RV80-RV80) 与同步的LV节奏预测了CRT后更好的LV功能.
- 较低的RV80与更好的CRT前RV喷射率相关,并预测CRT后心肌氧吸收改善.
- 较低的LV80与BIV节奏预测了较低的CRT后BNP水平,表明心脏功能有所改善.
结论:
- 三维电图有效地预测了CRT后有利的结果.
- 电气映射为定制有效的CRT节奏策略提供了宝贵的见解.
- 这种非侵入性映射技术为优化CRT治疗提供了一个有希望的方法.
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