单极与双极潜在基于激活的差异,来自心室外流通道产生的心室过早收缩的地图
Yoshimori J An1, Masafumi Sugawara1, Jakub Sroubek1
1Cardiac Electrophysiology Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Journal of cardiovascular electrophysiology
|March 24, 2025
概括
与手动绘图相比,用于识别出流通道室内过早收缩 (VPC) 中最早激活部位 (EAS) 的自动化算法显示空间差异. 这种差异在主动脉鼻尖端 (ASC) 起源的VPC中最为显著,需要仔细解释才能进行有效的切除.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械 医疗器械
背景情况:
- 使用单极电位 (-dV/dTmax) 识别出流通道 (OT) 中最早激活位点 (EAS) 的自动化算法的准确性,在切除过程中进行心室过早收缩 (VPC).
- 了解自动化和手动映射之间的空间差异对于优化废弃策略至关重要.
研究的目的:
- 通过自动单极 -dV/dTmax注释与手动双极电位注释识别的OT-VPC的EAS空间位置进行比较.
- 分析VPC的起源地点如何影响这两种绘图方法之间的空间差异.
主要方法:
- 分析了79名患有频繁OT-VPC的患者,这些患者经历了成功的切除.
- VPC的起源包括右心室OT (RVOT) 自由壁,RVOT隔膜,大动脉中枢连续性 (AMC) 和大动脉鼻尖端 (ASC).
- 通过自动化和手动方法确定EAS之间的空间距离被计算并通过不同VPC来源进行比较.
主要成果:
- 在自动化和手动映射之间观察到EAS的显著空间差异,特别是在ASC来源的VPC (非ASC来源的中位数为11.9mm与1.2mm,p <0.001).
- 在非ASC来源中,在RVOT自由壁VPC中发现的空间差异最小 (中位数为0毫米),在RVOT隔膜 (1.6毫米) 和AMC (2.2毫米) VPC中发现的差异较大.
结论:
- 对于EAS识别的单极和双极映射之间的空间不一致性取决于VPC来源.
- 在ASC起源的VPC中明显的差异凸显了对自动注释算法的谨慎解释的需要,以确保精确的本地化和成功的删除.
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