A Pitfall in Using Far‐Field Bipolar Electrograms in Arrhythmia Discrimination in a Patient with an Implantable Cardioverter Defibrillator
A Pitfall in Using Far‐Field Bipolar Electrograms in Arrhythmia Discrimination in a Patient with an Implantable Cardioverter Defibrillator
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使用远场双极电图辨别植入式心脏复律除颤器患者心律失常的陷阱
DOI：
10.1111/j.1540-8159.1997.tb05447.x
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
D. Mehta
中科院分区：
文献类型：
--
作者：
H. Nayak;L. Tsao;F. Santoni‐Rugiu;J. Gomes;D. Mehta
双极远场电极的存储电描记图分析被认为可用于区分室上性和室性心律失常。本文报告一例因窦性心动过速而使用不适当的ICD电击的病例，其连续电击导致心室电图明显增宽。对这些从远场双极电极记录的存储电描记图的分析给出了室性心动过速的假象。扩大是由于损伤效应的电流，可能是两个电极之间大量介入心肌的结果。虽然分析来自远场双极电极的记录通常是有用的，但它并不总是可靠的，因为与基线节律相关的电描记图形态学的变化可能由其他因素（如损伤电流）引起。
Analysis of stored electrograms from bipolar far‐field electrodes is considered to be useful in differentiating supraventricular from ventricuiar arrhythmias. A case of inappropriate ICD shocks for sinus tachycardia is presented whereby successive shocks caused marked widening of the ventricuiar electrograms. Analysis of these stored electrograms, recorded from far‐field bipolar electrodes, gave the false impression of ventricuiar tachycardia. The widening was due to the current of injury effects, probably a consequence of the large amount of intervening myocardium between the bipoies. While analyzing recordings from far‐field bipolar electrodes is generally useful, it is not always reliable, for changes in electrogram morphoiogy, reiative to baseline rhythm, may result from other factors like current of injury.