Localization of the slow conduction zone during reentrant ventricular tachycardia.
Localization of the slow conduction zone during reentrant ventricular tachycardia.
复制标题
折返性室性心动过速期间慢传导区的定位。
DOI：
10.1161/01.cir.102.4.464
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发表时间：
2000
期刊：
影响因子：
37.8
通讯作者：
Ciaccio,EJ
中科院分区：
文献类型：
--
作者：
Ciaccio,EJ
背景-折返性室性心动过速有时很难有效治疗，因为定位慢传导区(SCZ)用于导管消融可能存在问题。假设在SCZ中激活波前加速和减速分别与远场细胞外信号的收缩和扩张之间存在线性关系，可用于SCZ的定位。方法和结果-为了验证这一假设，根据记录位置的激活和电信号远场偏移量之间的时间间隔，建立了一个近似SCZ位置的模型。记录从196~312个心外膜部位(犬模型，8次)的心外膜折返期的心电图。建立了再入激活图以确定波前速度，并用分段线性自适应模板匹配(PLATM)方法测量了远场电信号偏移量的时移。心动过速时多出现周期长度变化的线性趋势(平均趋势为+15ms/96.8个心动周期；R2=0.92)。通过SCZ激活的时间间隔的变化与心动过速周期长度的变化相似(平均符合率为75.7%)。PLATM测量的远场细胞外波形时移的开始和结束时间分别预测了从记录部位激活到SCZ近端和远端边缘激活的时间(激活标测的平均绝对误差为20.3ms)。结论-在折返过程中，PLATM估计了从电路附近任何记录点的激活到SCZ激活的时间间隔。PLATM时间间隔可转换为沿电路的弧长，以便可能更快速和准确地更新指向SCZ的手持式探头，以便进行导管消融。
Background—Reentrant ventricular tachycardia is sometimes difficult to treat effectively because localizing the slow conduction zone (SCZ) for catheter ablation may be problematic. It was hypothesized that a linear relationship exists between activating wave-front acceleration and deceleration in the SCZ and, respectively, contractions and expansions of the far-field extracellular signal, which could be used for SCZ localization.Methods and Results—To test the hypothesis, a model was developed to approximate SCZ location on the basis of the time interval between activation at the recording site and shifts in electrogram far-field deflections. Electrograms were recorded during reentry from 196 to 312 epicardial sites (canine model, 8 episodes). Activation maps of reentry were constructed to determine wave-front velocity, and piecewise linear adaptive template matching (PLATM) measured time shifts in far-field electrogram deflections. Linear trends of cycle length change often occurred during tachycardia (mean trend, +15 ms/96.8 cardiac cycles;r2=0.92). Alteration in the time interval for activation through the SCZ approximated the change in tachycardia cycle length (mean correspondence, 75.7%). The beginning and end times of far-field extracellular waveform time shifts measured by PLATM predicted the time from recording site activation to activation at the SCZ proximal and distal edges, respectively (mean absolute error with respect to activation mapping, 20.3 ms).Conclusions—During reentry, PLATM estimates the time interval from activation at any recording site near the circuit to SCZ activation. PLATM time intervals are convertible to arc lengths along the circuit for potentially more rapid and accurate update of a hand-held probe toward the SCZ for catheter ablation.
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影响因子：
4.8
作者：
A. Geibel;M. Zehender;P. Brugada
通讯作者：
P. Brugada
DOI：
10.1016/0735-1097(95)00086-j
发表时间：
1995-06-01
影响因子：
24
作者：
DOWNAR, E;SAITO, J;HARRIS, L
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DOI：
--
发表时间：
1999
期刊：
Cardiovascular Electrophysiology
影响因子：
--
作者：
E. Ciaccio;M. Scheinman;Vitaliy Fridman;H. Schmitt;J. Coromilas;A. L. Wit
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A. L. Wit
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DOI：
10.1111/j.1540-8159.1997.tb05447.x
发表时间：
1997
期刊：
Pacing and Clinical Electrophysiology
影响因子：
--
作者：
H. Nayak;L. Tsao;F. Santoni‐Rugiu;J. Gomes;D. Mehta
通讯作者：
D. Mehta
射频导管消融治疗心肌病相关室性心动过速的疗效。
DOI：
10.1253/jcj.61.55
发表时间：
1997
期刊：
Japanese circulation journal
影响因子：
--
作者：
M. Sato;M. Sakurai;A. Yotsukura;T. Betsuyaku;T. Ito;I. Yoshida;A. Kitabatake
通讯作者：
A. Kitabatake