Demonstration of the presence of slow conduction during sustained ventricular tachycardia in man: use of transient entrainment of the tachycardia.
Demonstration of the presence of slow conduction during sustained ventricular tachycardia in man: use of transient entrainment of the tachycardia.
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证明人类持续性室性心动过速期间存在慢传导：使用心动过速的瞬时夹带。
DOI：
10.1161/01.cir.75.2.369
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发表时间：
1987
期刊：
影响因子：
37.8
通讯作者：
Waldo,AL
中科院分区：
文献类型：
--
作者：
Okumura,K;Olshansky,B;Henthorn,RW;Epstein,AE;Plumb,VJ;Waldo,AL
为了验证人类重入性室性心动过速存在慢传导区域的假设，以及室性心动过速的最早激活位点在再入循环慢传导区域内或正正远端，我们研究了9例缺血性心脏病患者诱导的12次室性心动过速（平均速率185±32次/分）。在室性心动过速期间在选定的部位进行快速心室起搏，同时记录相对于QRS复合体起始的早期激活部位（A部位）和靠近起搏部位（B部位）的心电图。在室性心动过速伴有右束支传导阻滞时从右室心尖处快速起搏，以及在室性心动过速伴有左束支传导阻滞时从选定的左室部位快速起搏（平均起搏速率为202 +/- 38次/分），在12次发作中有11次在心电图上显示除了最后一次捕获的心跳（即室性心动过速被夹带）外，心室融合心跳不变。在雾沫:A、B部位在起搏速率下被激活，从最后一次起搏脉冲到A部位（St-A间期）最后一次捕获心室电图的传导时间为359 +/- 69 msec，跨越舒张期，而B部位（St-B间期）的传导时间仅为28 +/- 13 msec， A部位的心室电图形态与室性心动过速时相同，而B部位的电图形态不同。表明A位点在夹带和室性心动过速时的激活方向相同。8次室性心动过速以两种或两种以上不同的起搏速率发生。8次发作中有4次起搏时St-A间期以更快的速率增加，而St-B间期保持不变。在窦性心律（平均起搏率201 +/- 37次/分）时从同一部位进行快速心室起搏导致St-A间期为103 +/- 37 msec （p < 0.05）。St-B间隔为31±15毫秒（p = NS与夹带期间的值相比）。由此可见，室性心动过速存在窦性心律不明显的慢传导区，室性心动过速最早的激活位点在该慢传导区远端或正侧远端。
To test the hypothesis that an area of slow conduction is present during reentrant ventricular tachycardia in man, and that the earliest activation site during ventricular tachycardia is within or orthodromically just distal to the area of slow conduction in the reentry loop, we studied 12 episodes of ventricular tachycardia (mean rate 185 +/- 32 beats/min) that were induced in nine patients with ischemic heart disease. Rapid ventricular pacing was performed at selected sites during ventricular tachycardia while recording electrograms from an early activation site relative to the onset of the QRS complex (site A) and from a site close to the pacing site (site B). Rapid pacing from the right ventricular apex during ventricular tachycardia with a right bundle branch block pattern and from selected left ventricular sites during ventricular tachycardia with a left bundle branch block pattern (mean pacing rate 202 +/- 38 beats/min) resulted in constant ventricular fusion beats on the electrocardiogram except for the last captured beat (i.e., the ventricular tachycardia was entrained) in 11 of 12 episodes. During entrainment: sites A and B were activated at the pacing rate, conduction time from the last pacing impulse to the last captured ventricular electrogram at site A (St-A interval) was 359 +/- 69 msec and spanned the diastolic interval, while that at site B (St-B interval) was only 28 +/- 13 msec, site A had the same ventricular electrogram morphology as that during ventricular tachycardia, while site B had a different electrogram morphology, indicating that site A was activated in the same direction during entrainment as during ventricular tachycardia. Eight episodes of ventricular tachycardia were entrained at two or more different pacing rates. The St-A interval increased during pacing at the faster rate(s) in four of eight episodes, while the St-B interval remained unchanged. Rapid ventricular pacing performed from the same site during sinus rhythm (mean pacing rate 201 +/- 37 beats/min) resulted in an St-A interval of 103 +/- 37 msec (p less than .001 vs the value during entrainment) and an St-B interval of 31 +/- 15 msec (p = NS vs the value during entrainment). It is concluded that an area of slow conduction not demonstrable during sinus rhythm exists during ventricular tachycardia, and that the earliest activation site during ventricular tachycardia is at or orthodromically distal to this area of slow conduction.
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DOI：
10.1016/0002-9149(84)90581-2
发表时间：
1984
期刊：
The American journal of cardiology
影响因子：
--
作者：
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影响因子：
24
作者：
D. Mann;G. Lawrie;J. Luck;J. Griffin;S. Magro;C. Wyndham
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在犬心肌梗塞制剂中通过程序刺激诱导的室性心动过速的绘图。
影响因子：
37.8
作者：
R. Cardinal;P. Savard;D. L. Carson;J. Perry;P. Pagé
通讯作者：
P. Pagé
影响因子：
20.1
作者：
ELSHERIF, N;SMITH, RA;EVANS, K
通讯作者：
EVANS, K
DOI：
10.1016/0002-9149(85)90853-7
发表时间：
1985
期刊：
The American journal of cardiology
影响因子：
--
作者：
J. Almendral;C. Gottlieb;F. Marchlinski;A. Buxton;J. U. Doherty;M. Josephson
通讯作者：
M. Josephson