试点研究评估左至右心室偏移在双心室节奏-比较心电图像和心电图像和心电图的试点研究
Amit Noheria1, Ahmed Shahab1, Christopher Andrews2
1Department of Cardiovascular Medicine, The University of Kansas Medical Center, Kansas City, Kansas, USA.
Journal of cardiovascular electrophysiology
|April 9, 2024
概括
优化双心室节奏 (BiVp) 需要调整左心室 (LV) 和右心室 (RV) 的刺激偏移. 电心图像 (ECGI) 有助于最大限度地减少电解,使用3D-QRS区域作为最佳LV-RV偏移的可靠指标.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 电力生理学 电力生理学
背景情况:
- 双管节律节奏 (BiVp) 对于改善心力衰竭患者的结局至关重要.
- BiVp利用心脏左心室 (LV) 和内心室右心室 (RV) 电极进行心脏再同步治疗.
- 个性化BiVp编程可以通过分析急性电激活变化与不同的LV-RV刺激偏移来指导.
研究的目的:
- 为了研究不同LV-RV刺激偏移的双心室节奏心室激活模式.
- 为了将心电成像 (ECGI) 发现与标准的12导心电图参数进行比较.
- 为了确定最大限度地减少心室电解 (VEUabs) 的最佳LV-RV偏移.
主要方法:
- 在五名BiVp患者中使用ECGI评估了急性心室内膜激活.
- 多种LV-RV偏移在20毫秒的增量从-40毫秒到80毫秒.
- 评估绝对心室电解 (VEUabs) 和总激活时间 (TAT),将ECGI与3D-QRS区域和QRS持续时间相关联.
主要成果:
- 在个体患者中,最小化VEUabs的最佳LV-RV偏移范围在20-60ms之间.
- 为了达到最小的VEUabs或3D-QRS区域,与最小的TAT或QRS持续时间相比,需要更大的LV-RV抵消.
- 3D-QRS区域与VEUabs相关 (r=0.65),QRS持续时间与TAT相关 (r=0.95). 最小的VEUabs和3D-QRS区域是通过在20ms内相互抵消LV-RV实现的.
结论:
- 优化LV-RV刺激偏移可以显著降低心室电解,正如ECGI所示.
- 3D-QRS区域作为一种有价值的替代标记,用于识别最小化LV-RV脱的LV-RV偏移.
- 使用ECGI衍生的指标对BiVp进行个性化编程可以提高治疗疗效.
关键词:
优化CRT的优化方式这是一个ECGECGECGECGECG.在ECGI上,它是ECGI的.在QRS的区域,QRS的区域.QRS的持续时间心脏再同步治疗心脏再同步治疗电心图像成像电心图像成像总的激活时间.室内电气解器的电气解更多相关视频
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