Effects of distant potentials on unipolar electrograms in an animal model utilizing the right ventricular isolation procedure.
Effects of distant potentials on unipolar electrograms in an animal model utilizing the right ventricular isolation procedure.
复制标题
利用右心室隔离程序的动物模型中远距离电位对单极电图的影响。
DOI：
10.1016/s0735-1097(98)90071-7
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发表时间：
1988
影响因子：
24
通讯作者：
Lowe,JE
中科院分区：
文献类型：
--
作者：
DamianoJr,RJ;Blanchard,SM;Asano,T;Cox,JL;Lowe,JE
在5只狗的双侧脑室可独立起搏的模型上，研究了远距离电位对局部心外膜单极电信号的影响。右室隔离程序将右室与左室电隔离。通过改变左、右室起搏间隔，将右室心电图分离为局部(右室)和远端(左室)成分。在有无左室远端电位的情况下，仔细评估每个电极部位的波形形态、峰峰幅度、斜率大小和最快下搏的时间。除最快下搏的时间外，所有这些变量都明显受远端电位的影响。尽管最快下击的斜率明显受到远距离电位的影响，但它仍然是局部与远距离激活的敏感指标。所有右室局部活动的心电图的斜率均为2.5 mV/2ms，而仅包含远端左室活动的右室心电图均无一例出现2.5 mV/2ms的斜率。计算机生成的心电图通过将记录的局部右室和远端左心室成分进行数字求和来计算。同步起搏时模拟的心电信号与记录的心电信号有很好的相关性，因此远距离电位对单极电极的形态、幅度和斜率有很大的影响。最快下击的时间在很大程度上与远处电位的影响无关，最接近地代表局部激活。记录的心电图斜率的大小准确地区分了局部和远处的活动。
The effects of distant potentials on local epicardial unipolar electrograms were examined utilizing a model that enabled both ventricles to be paced independently in five dogs. The right ventricular isolation procedure electrically isolates the right from the left ventricle. Right ventricular electrograms were separated into their local (right ventricular) and distant (left ventricular) components by altering the left-right ventricular pacing interval. Waveform configuration, peak to peak amplitude, magnitude of the slope and timing of the fastest downstroke were carefully evaluated at each electrode site, both with and without the presence of distant left ventricular potentials.Except for the timing of the fastest downstroke, all of these variables were significantly altered by distant potentials. Although the slope of the fastest downstroke was significantly affected by distant potentials, it remained a sensitive indicator of local versus distant activation. All electrograms of local right ventricular activation had a slope magnitude >2.5 mV/2 ms whereas none of the right ventricular electrograms containing only distant left ventricular activity had a magnitude >2.5 mV/2 ms. Computergenerated electrograms were calculated by digitally summing the recorded local right and distant left ventricular components. The simulated electrograms correlated well with the recorded electrograms during synchronous ventricular pacing.Thus, the configuration, amplitude and slope of unipolar electrodes were profoundly influenced by distant potentials. The timing of the fastest downstroke is largely independent of the effect of distant potentials and most closely represents local activation. The magnitude of the slope of the recorded electrogram accurately distinguishes local from distant activation.