Mapping Ventricular Tachycardia With Electrocardiographic Imaging.
Mapping Ventricular Tachycardia With Electrocardiographic Imaging.
复制标题
通过心电图成像绘制室性心动过速图。
DOI：
10.1161/circep.120.008255
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Wang,Linwei
中科院分区：
文献类型：
--
作者：
Sapp,JohnL;Zhou,Shijie;Wang,Linwei
室性心动过速（VT）的研究和治疗应该是心电图成像（ECGI）产生重大临床影响的绝佳机会。瘢痕相关性室性心动过速是一个重要的问题，具有高疾病负担，有有效的治疗选择。1 VT具有相对大的心电图信号和高信噪比，心脏传导系统对心肌激活的影响较小。现在有大量的文献是关于从体表电位和心脏-躯干几何信息（通常称为ECGI）逆计算心脏电活动的。2尽管ECGI用于定位立体定向放射消融的靶点，允许完全无创的手术，3但其作为临床心律失常定位的独立方法的使用受到限制。ECG准确性的定量临床验证一直具有挑战性。Graham等人4收集了一个相对较大的系列患者，这些患者接受了导管消融的同时侵入性电生理研究，同时ECGI电极到位，以量化ECGI在定位室性心动过速从心肌瘢痕退出的部位方面的准确性。这些数据很有价值，但很难获得：导管消融术期间胸部的真实的状态非常珍贵，电解剖标测系统定位贴片、除颤垫和手术12导联ECG电极与体表电位标测电极争夺空间。
The study and treatment of ventricular tachycardia (VT) should be an excellent opportunity for electrocardiographic imaging (ECGI) to make a significant clinical impact. Scar-related VT is an important problem with a high burden of disease that has effective therapeutic options. 1 VT has a relatively large electrocardiographic signal, and a high signal-to-noise ratio, with a lesser impact of the cardiac conduction system on myocardial activation. There is now a substantial body of literature regarding inverse calculation of cardiac electrical activity from body surface potentials and heart-torso geometry information, often known as ECGI. 2 Although ECGI was used for localization of target sites for stereotactic radioablation, permitting an entirely noninvasive procedure, 3 its use as a standalone means for clinical arrhythmia localization has otherwise been limited. Quantitative clinical validation of the accuracy ECG has been challenging. Graham et al4 are to be congratulated for the assembly of a relatively large series of patients who underwent simultaneous invasive electrophysiological study with catheter ablation, while ECGI electrodes were in place to quantitate the accuracy of ECGI in localizing sites of VT exit from myocardial scar. These data are valuable and difficult to acquire: real estate on the thorax during a catheter ablation procedure is at a premium, with electroanatomical mapping system localization patches, defibrillation pads, and procedural 12-lead ECG electrodes competing for space with electrodes for body surface potential mapping.