A Computerized Method for the Rapid Display of Ventricular Activation During the Intraoperative Study of Arrhythmias
A Computerized Method for the Rapid Display of Ventricular Activation During the Intraoperative Study of Arrhythmias
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心律失常术中研究中快速显示心室激动的计算机化方法
DOI：
10.1161/01.cir.59.3.449
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发表时间：
1979
期刊：
影响因子：
37.8
通讯作者：
J. Gallagher
中科院分区：
文献类型：
--
作者：
R. Ideker;W. Smith;A. Wallace;J. Kasell;L. Harrison;G. Klein;R. Kinicki;J. Gallagher
在室性心动过速的术中研究中，仅持续几个周期或表现出不同周期的激活序列变化的心律失常可能发生。为了绘制这些短暂的、变化的心律失常，需要同时从多个地点进行记录，这是无法用单个手持电极探针完成的。因此，开发了一种计算机化的方法，可以同时记录多达27个电极的电位，并快速显示心外膜和跨壁激活序列。使用了三组电极。第一组电极分布在两个心室的心外膜上，并固定在一个柔性尼龙网袜中。第二个阵列的电极形成一个3平方厘米的网格，用于获得心外膜小区域的更详细的激活图。第三个阵列的电极沿着穿过心肌的针轴间隔，以记录跨壁激活。从一组电极记录的电位和计算机选择的电极激活时间被显示出来供视觉检查，然后绘制出激活图。记录电位10分钟后可显示单个周期的激活顺序。从袜子阵列获得的激活图确定网格阵列的位置；由网格阵列产生的映射决定了针阵列的位置。因此，如果心律失常可以诱导三次或三次以上，则可以确定负责启动心律失常的区域。
Arrhythmias which last for only a few cycles or exhibit activation sequences that change from cycle to cycle may occur during the intraoperative study of ventricular tachyarrhythmias. To map these transient, varying arrhythmias requires recording from numerous sites simultaneously, which cannot be done with a single, hand-held electrode probe. Therefore, a computerized method was developed to record potentials simultaneously from up to 27 electrodes and to display epicardial and transmural activation sequences rapidly.Three arrays of electrodes are used. The electrodes of the first array are distributed over the epicardium of both ventricles and fixed within a flexible nylon mesh sock. The electrodes of the second array form a 3-cmsquare grid and are used to obtain a more detailed activation map of a small region of epicardium. The electrodes of the third array are spaced along the shafts of needles that are inserted through the myocardium to record transmural activation. The potentials recorded from an array of electrodes and the computer-selected activation times at the electrodes are displayed for visual inspection after which a map of activation is drawn. The activation sequence of a single cycle can be displayed 10 minutes after recording the potentials. The activation map obtained from the sock array determines the placement of the grid array; the map resulting from the grid array determines the placement of the needle array. Thus, the region responsible for initiating an arrhythmia can be determined if the arrhythmia can be induced three or more times.