The electrophysiological cardiac ventricular substrate in patients after myocardial infarction: noninvasive characterization with electrocardiographic imaging.
The electrophysiological cardiac ventricular substrate in patients after myocardial infarction: noninvasive characterization with electrocardiographic imaging.
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DOI：
10.1016/j.jacc.2011.07.029
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发表时间：
2011-10-25
影响因子：
24
通讯作者：
Rudy, Yoram
中科院分区：
文献类型：
--
作者：
Cuculich, Phillip S.;Zhang, Junjie;Wang, Yong;Desouza, Kavit A.;Vijayakumar, Ramya;Woodard, Pamela K.;Rudy, Yoram
目的：对心肌梗死后的人脑室电生理底物进行无创性成像，明确其特点。室梗塞边缘带以细胞电生理异常和结构改变为特征，是心律失常发生的关键因素。无创性地成像其电学特征的能力有助于理解机制和室性心律失常的风险分层。对24例心肌梗死相关瘢痕患者在窦性心律时进行了无创功能电生理成像检查。对瘢痕的心外膜部位的异常电生理底物进行鉴定，并将其位置、大小和形态与其他非侵入性成像的解剖瘢痕进行比较。ECGI构建的心外膜心外膜电信号具有幅度降低(低电压)和分离的特点。ECGI将心外膜电性瘢痕与解剖瘢痕共定位，准确率高(敏感性89%，特异性85%)。在几乎所有受试者中，窦性心律的激活模式都受到心肌瘢痕的影响。晚电位可被识别，且几乎总是在脑室疤痕内。ECGI可准确识别解剖疤痕区域，并通过提供与疤痕相关的电生理特征(低电压、窦性心律激活改变、电信号碎裂和存在晚电位)来补充标准的解剖成像。
To noninvasively image the electophysiologic substrate of human ventricles after myocardial infarction and define its characteristics. Ventricular infarct border zone is characterized by abnormal cellular electrophsyiology and altered structural architecture and is a key contributor to arrhythmogenesis. The ability to noninvasively image its electrical characteristics could contribute to understanding of mechanisms and to risk-stratification for ventricular arrhythmia. Electrocardiographic Imaging (ECGI), a noninvasive functional electrophysiologic imaging modality, was performed during sinus rhythm in 24 subjects with infarct-related myocardial scar. The abnormal electrophysiologic substrate on the epicardial aspect of the scar was identified and its location, size, and morphology were compared to the anatomic scar imaged by other noninvasive modalities. ECGI constructs epicardial electrograms which have characteristics of reduced amplitude (low voltage) and fractionation. ECGI co-localizes the epicardial electrical scar to the anatomic scar with a high degree of accuracy (sensitivity 89%, specificity 85%). In nearly all subjects, sinus rhythm activation patterns were affected by the presence of myocardial scar. Late potentials could be identified and were almost always within ventricular scar. ECGI accurately identifies areas of anatomic scar and complements standard anatomic imaging by providing scar - related electrophysiologic characteristics of low voltages, altered sinus rhythm activation, electrogram fragmentation and presence of late potentials.
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影响因子：
37.8
作者：
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影响因子：
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作者：
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通讯作者：
COLAVITA, PG