Single-Beat Noninvasive Imaging of Ventricular Endocardial and Epicardial Activation in Patients Undergoing CRT
Single-Beat Noninvasive Imaging of Ventricular Endocardial and Epicardial Activation in Patients Undergoing CRT
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DOI：
10.1371/journal.pone.0016255
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发表时间：
2011-01-27
期刊：
影响因子：
3.7
通讯作者：
Seger, Michael
中科院分区：
文献类型：
--
作者：
Berger, Thomas;Pfeifer, Bernhard;Seger, Michael
背景：关于心脏再同步治疗（CRT）对心内膜和心外膜心室激活的影响知之甚少。心脏电生理学无创成像 (NICE) 是一种新型成像工具，用于可视化心外膜和心内膜心室电激活。方法/主要发现：NICE 在 10 名接受 CRT 的充血性心力衰竭 (CHF) 患者和 10 名无结构性心脏病的患者（对照组）中进行。 NICE 融合了高分辨率心电图测绘数据与磁共振成像创建的患者个体心胸解剖模型。使用基于双域理论的心脏模型计算自然心律期间以及心室起搏期间的逐次心内膜和心外膜心室激活序列，以解决相关的逆问题。在右心室 (RV) 起搏控制期间，患者表现出心室激活序列的恶化，类似于 CHF 患者的内在激活模式。与对照组相比，CHF 患者的左心室传播速度显着降低（1.6 +/- 0.4 与 2.1 +/- 0.5 m/sec；p
Background: Little is known about the effect of cardiac resynchronization therapy (CRT) on endo-and epicardial ventricular activation. Noninvasive imaging of cardiac electrophysiology (NICE) is a novel imaging tool for visualization of both epi- and endocardial ventricular electrical activation.Methodology/Principal Findings: NICE was performed in ten patients with congestive heart failure (CHF) undergoing CRT and in ten patients without structural heart disease (control group). NICE is a fusion of data from high-resolution ECG mapping with a model of the patient's individual cardiothoracic anatomy created from magnetic resonance imaging. Beat-to-beat endocardial and epicardial ventricular activation sequences were computed during native rhythm as well as during ventricular pacing using a bidomain theory-based heart model to solve the related inverse problem. During right ventricular (RV) pacing control patients showed a deterioration of the ventricular activation sequence similar to the intrinsic activation pattern of CHF patients. Left ventricular propagation velocities were significantly decreased in CHF patients as compared to the control group (1.6 +/- 0.4 versus 2.1 +/- 0.5 m/sec; p