概括
这项研究表明,缺血性心脏病中的心室动脉冲动在心肌梗塞的内心表面附近产生. 仅仅对心上表皮进行测绘是不够的,无法精确地确定这些心室动脉动脉障的起源.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏外科手术 心脏外科手术
背景情况:
- 复发性心室低心率 (VT) 是患有冠状动脉疾病 (CAD) 和心肌梗塞 (MI) 的患者的重大并发症.
- 精确识别VT来源对于有效治疗至关重要,通常涉及手术干预.
研究的目的:
- 在患有缺血性心脏病的患者中,调查静脉治疗期间心室激活的确切来源.
- 评估表皮心脏映射与结合表皮心脏和内心脏映射用于识别静脉瘤基质的充分性.
主要方法:
- 在21名患有CAD和先前心肌梗塞的患者中进行了手术期间的表皮心脏和内心脏映射,这些患者因复发性静脉瘤而接受手术.
- 用广泛的电图记录 (55-75 副心脏,28-55 内心脏部位) 诱导和绘制了心室动脉动脉障 (29 种不同的形态).
- 测绘数据与心电图和参考电图一起分析,以确定最早的激活地点.
主要成果:
- 最早的心室激活始终发生在心脏梗塞区域的内心表面,在所有映射的心跳动中.
- 内心电活动先于QRS复杂的发作,表明起源.
- 最早的表心激活是延迟的 (10msec后QRS),表心突破发生在两个心室.
结论:
- 在缺血性心脏病中,心室性心力衰竭起源于左心室的内心表面,与心脏梗塞边界相邻.
- 仅靠心脏表皮图绘制就不足以准确地定位这些VT基质的起源.
- 结合内心和上心的映射对于在这种患者群体中精确识别VT起源至关重要.
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