SLOW CONDUCTION, FRACTIONATION, AND SIGNAL-AVERAGED ECG

慢传导、分割和信号平均心电图

• 批准号: 3449130
• 负责人: ROGER A FREEDMAN
• 金额: $ 5.34万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 1985
• 资助国家: 美国
• 起止时间: 1985-12-01 至 1988-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3449130
• 关键词: electrocardiography; electrophysiology; epicardial mapping; heart conduction system; heart disorder diagnosis; myocardial infarction; noninvasive diagnosis; ventricular fibrillation

Ventricular arrhythmias are a major source of morbidity and mortality in this country. Most are caused by reentry, one prerequisite for which is slow conduction. Characterizing slow conduction may help in the understanding and treatment of ventricular arrhythmias. Fractionated epicardial electrograms are often detected in patients with ventricular arrhythmias, and they may arise from slowly-conducting myocardium. Recently, abnormal QRS/ST potentials have been detected with signal-averaged ECG on the body surface of patients with ventricular arrhythmias, and these may also arise from slowly-conducting myocardium. Abnormal QRS/ST potentials may in the future provide a noninvasive characterization of slow conduction in individual subjects. However, the relationships among slow conduction, fractionated epicardial electrograms, and abnormal body surface QRS/ST potentials need to be confirmed and quantitated. This application proposes to study three specific hypotheses in a canine model of chronic myocardial infarction: (1) fractionated electrograms arise from areas of slowly-conducting myocardium, (2) abnormal QRS/ST potentials are the body surface manifestation of fractionated electrograms, and (3) there is a correlation between the epicardial location of fractionated electrograms and the body surface location of abnormal QRS/ST potentials. Several novel techniques will be used in this proposal. First, local conduction velocity in the right ventricular free wall will be estimated using local activation times recorded simultaneously from 64 unipolar epicardial leads. Second, the spatial distribution of fractionated electrograms will be derived from the same 64 epicardial leads. Third, multiple simultaneous unipolar ECG's will be used for detection and localization of abnormal body surface QRS/ST potentials.

室性心律失常是发病率和死亡率的主要来源 这个国家。 大多数是由再入引起的，其先决条件之一是 传导缓慢。 表征慢传导可能有助于 室性心律失常的认识和治疗。 分次 心外膜电图常在心室性心律失常患者中检测到。 心律失常，它们可能是由传导缓慢的心肌引起的。 最近，发现异常 QRS/ST 电位 室性心律失常患者体表信号平均心电图 心律失常，这些也可能由传导缓慢的心肌引起。 异常的 QRS/ST 电位将来可能会提供非侵入性的治疗 个别受试者慢传导的特征。 然而， 慢传导、分段心外膜电图之间的关系、 需确认体表QRS/ST电位异常 定量。 本申请建议研究三个具体假设 在慢性心肌梗塞的犬模型中：（1）分次 电图来自慢传导心肌区域，(2) 异常 QRS/ST 电位是分割的体表表现 电图，（3）心外膜之间存在相关性 分段电图的位置和体表位置 QRS/ST 电位异常。 本提案将使用多种新技术。 一、本地 将估计右心室游离壁的传导速度 使用 64 个单极同时记录的本地激活时间 心外膜导联。 二、空间分布划分 电描记图将从相同的 64 条心外膜导联得出。 第三， 多个同时单极心电图将用于检测和 异常体表 QRS/ST 电位的定位。