Serial changes in epicardial electrograms during and after a coronary artery occlusion
Serial changes in epicardial electrograms during and after a coronary artery occlusion
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冠状动脉闭塞期间和之后心外膜电图的连续变化
DOI：
10.1007/s11748-010-0590-2
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发表时间：
2010
影响因子：
1.2
通讯作者：
K. Shimizu
中科院分区：
文献类型：
--
作者：
T. Fujimatsu;T. Nitta;Hajime Osawa;K. Shimizu
突然发生的室性快速性心律失常是非体外循环冠状动脉搭桥（OPCAB）手术期间的并发症，可能导致需要转换为体外循环手术。我们研究了一系列的变化，在心肌缺血的边界区域的电活动和不应性的空间分散在冠状动脉occlusion. Methods单极心外膜电图连续记录从左前心室的边界区域期间和10分钟闭塞后的左前降支（LAD）冠状动脉在22例OPCAB。分别通过单极峰间振幅（UPPA）和激动恢复间隔（ARI）评价局部电图振幅和局部不应期。使用这些参数的变异系数的电活动和不应期的空间分散进行了检查。UPPA离散度显着增加到5分钟后，LAD闭塞，然后返回到一个不显着的水平，再灌注后再次增加。ARI离散度逐渐增加后，LAD闭塞，闭塞后3分钟达到显着增加的水平，并停留在一个显着增加的水平至少5分钟后reperfusion.ConclusionThere是独特的系列变化的空间离散度的电活动和不应性在心肌缺血的边界区期间和之后冠状动脉闭塞。连续监测这些参数可能有助于预测OPCAB患者发生室性快速性心律失常的关键电生理条件。
ObjectiveSuddenly occurring ventricular tachyarrhythmias are a complication during off-pump coronary artery bypass (OPCAB) surgery, potentially leading to the need for conversion to on-pump surgery. We examined serial changes in the spatial dispersion of the electrical activity and refractoriness at the myocardial ischemia border zones during and after coronary occlusion.MethodsUnipolar epicardial electrograms were continuously recorded from the anterior left ventricle at the border zones during and after a 10-min occlusion of the left anterior descending (LAD) coronary artery in 22 patients undergoing OPCAB. The local electrogram amplitude and local refractoriness were evaluated by the unipolar peak-to-peak amplitude (UPPA) and activation recovery interval (ARI), respectively. The spatial dispersion of the electrical activity and refractoriness were examined using the coefficient of variation of these parameters.ResultsNo sustained ventricular tachyarrhythmias occurred in any patients. The UPPA dispersion significantly increased up to 5 min after the LAD occlusion and then returned to a nonsignificant level and again increased after reperfusion. The ARI dispersion gradually increased after the LAD occlusion, reached a significantly increased level 3 min after the occlusion, and stayed at a significantly increased level for at least 5 min after the reperfusion.ConclusionThere were unique serial changes in the spatial dispersion of the electrical activity and refractoriness at the myocardial ischemia border zones during and after coronary occlusions. Continuous monitoring of these parameters may be useful for predicting the critical electrophysiological conditions prone to the occurrence of ventricular tachyarrhythmias in patients undergoing OPCAB.
心室冷冻手术：对壁内电生理学的短期影响。
DOI：
10.1016/s0003-4975(10)61589-5
发表时间：
1983
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
Holman,WL;Ikeshita,M;DouglasJr,JM;Smith,PK;Lofland,GK;Cox,JL
通讯作者：
Cox,JL
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。
影响因子：
24
作者：
DamianoJr,RJ;Blanchard,SM;Asano,T;Cox,JL;Lowe,JE
通讯作者：
Lowe,JE