电心电图的特征,识别和管理频繁的早发性心室收缩
Dimitris Tsiachris1,2, Michail Botis1, Ioannis Doundoulakis1
1First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, "Hippokration" Hospital, 11527 Athens, Greece.
Diagnostics (Basel, Switzerland)
|October 14, 2023
概括
早发性心室复合体 (PVCs) 可以影响心脏功能,特别是在高负担的情况下. 心脏MRI有助于在没有结构性心脏病的患者的预后,而心电图和人工智能有助于定位PVC来源以进行有效的治疗.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 心血管成像 - 心血管成像
背景情况:
- 在临床实践中,早发性心室复合体 (PVC) 是常见的.
- 它们与不良结果的联系在结构性心脏病中是已知的,但在没有心脏病的情况下则不那么清楚.
- 心脏磁共振 (CMR) 可能在没有结构性心脏病的PVC患者中提供预后价值.
研究的目的:
- 探索CMR在没有结构性心脏病的PVC患者的预后作用.
- 审查用于定位PVC来源的方法,包括ECG算法和AI.
- 讨论PVCs的管理策略,重点关注症状和PVC诱导的心肌功能障碍.
主要方法:
- 对PVCs,CMR,ECG和AI在心律失常局部化方面的现有文献的审查.
- 对诊断算法的分析,以区分右心室 (RVOT) 和左心室外流通道 (LVOT) 的PVC来源.
- 评估治疗选择,包括药物治疗和导管切除.
主要成果:
- 高PVC负担 (>10%) 与PVC诱导的心肌功能障碍有关.
- 使用表面心电图和新算法 (包括人工智能) 来确定PVC原产地.
- 与症状性PVC或功能障碍的药物治疗相比,导管切除显示出更高的疗效和安全性.
结论:
- 在缺乏结构性心脏病的PVC患者中,CMR具有预后意义.
- 使用心电图和人工智能准确地定位PVC来源对于指导治疗至关重要.
- 对于PVC的治疗决定,应考虑心肌功能障碍的症状和可能性,而切除通常是首选的治疗方式.
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