在早期激活部位的同时明显分散精确地识别出流管室内腔异位部位
Robert D Anderson1, Stephane Masse2, Joshua Hawson3
1Hull Family Cardiac Fibrillation Management Laboratory, Division of Cardiology, University Health Network, Toronto General Hospital, Toronto, ON, Canada; Department of Cardiology, Royal Melbourne Hospital, Faculty of Medicine, Dentistry, and Health Science, University of Melbourne, Melbourne, Vic, Australia.
Heart, lung & circulation
|January 31, 2025
概括
同时的表面分散 (IAD) 映射准确地区分了右心室和左心室的外流通道. 过早心室复合体 (PVC) 的起源. 这种新的方法通过识别最佳的废弃部位来指导成功的导管废弃.
科学领域:
- 电力生理学 电力生理学
- 绘制心脏地图是指绘制心脏地图.
- 导管切除术 导管切除术 导管切除术
背景情况:
- 在外流通道 (OT) 中定位早发性心室复合体 (PVC) 起源通常依赖于局部激活时间 (LAT) 映射.
- 基于LAT的方法对室内或远处的PVC焦点可能不准确,特别是当深度焦点表现出快速导电速度 (CV) 时.
研究的目的:
- 为了评估超生理 CV 映射的有效性,称为同时明显分散 (IAD) 映射,用于准确区分右和左心室 OT PVC 起源.
- 确定IAD映射是否可以指导OT PVC的成功导管切除.
主要方法:
- 进行左心室OT映射,如果右心室OT映射显示双极电图 (EGM) <20毫秒.
- 分析了各种间隔的最早的EGM (例如,双极最早到QRS,双极最早到单极最早),并使用自定义的MATLAB算法计算了多项式CV.
- 使用计算CV开发了IAD映射,并评估了与传统EGM索引相比,其在区分成功和不成功的废弃地点方面的准确性.
主要成果:
- 双极最早到QRS间隔优于单极 -dV/dtmax到QRS在区分成功和不成功的OT PVC位点方面 (p<0.05).
- 一个早期的同时突破面积<1厘米2和<2个突破表明了成功的切除部位 (p<0.05).
- IAD绘制显示了93.8%的准确性,在区分成功和不成功的地点,表面分散指数切线为20,000厘米/秒 (AUC 0.95).
结论:
- IAD映射提供了对3D激活映射表面的现实的2D解释.
- IAD绘制显示了通过准确识别废除目标来指导OT PVC的成功导管废除的潜力.
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