BODY SURFACE LOCALIZATION OF QRS LATE POTENTIALS

QRS 晚电位的体表定位

• 批准号: 3471590
• 负责人: ROGER A FREEDMAN
• 金额: $ 12.9万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-08-01 至 1992-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3471590
• 关键词: electrocardiography; electrophysiology; human subject; myocardial infarction; noninvasive diagnosis; slow potential; sudden cardiac death; ventricular fibrillation

Ventricular arrhythmias are a major source of morbidity and mortality in this country. Pharmacologic treatment of these arrhythmias is often unsuccessful, and there is growing interest in surgical and catheter techniques at eliminating them. Recently, signal-averaged electrocardiography has been used to demonstrate abnormal deflections occurring at the terminus of the QRS complex in many patients with ventricular arrhythmias; these are known as "late potentials." Late potentials are thought to arise from localized areas of slowly-conducting myocardium, which is thought also to generate localized fractionated electrograms recordable directly on the cardiac surface. The extent of fractionated electrograms has been shown to correlate with the risk of arrhythmias, and the location of fractionated electrograms has been shown to correlate with areas of arrhythmogenic myocardium. Previous methods of detecting late potentials have not attempted to define their location on the body surface. Preliminary studies in a canine model of myocardial infarction from this laboratory have suggested that late potentials are localized to a contiguous area on the thorax. The primary hypothesis that this application proposes to study is that the location of late potentials indicates the epicardial location of fractionated electrograms and slow conduction, which in turn can guide ablative therapy of arrhythmias. This hypothesis will be examined both in a canine model of healed myocardial infarction and in patients with healed myocardial infarction. Substantiation of this hypothesis would allow for noninvasive determination of the extent and location of arrhythmogenic myocardium in patients with ventricular arrhythmias, which may help direct surgical and catheter ablation.

室性心律失常是发病率的一个主要来源 这个国家的死亡率。 药物治疗这些 心律失常通常是不成功的，人们越来越感兴趣 消除它们的手术和导管技术。 最近，信号平均心电图已被用于 证明末端发生异常偏转 许多室性心律失常患者的 QRS 波群； 这些被称为“晚期潜力”。 后期潜力被认为 源自缓慢传导心肌的局部区域， 这也被认为会产生局部分馏 可直接在心脏表面记录电图。 这 分割电图的范围已被证明与 存在心律失常的风险以及分次的位置 电描记图已被证明与区域相关 致心律失常的心肌。 以前没有尝试过检测晚期电位的方法 定义它们在身体表面的位置。 初步研究 在该实验室的犬心肌梗塞模型中 已经表明晚电位被定位于连续的 胸部区域。 该应用程序的主要假设 建议研究的是晚电位的位置表明 分段电图和慢速心外膜位置 传导，进而可以指导消融治疗 心律失常。 这个假设将在犬科动物中得到检验 治愈的心肌梗塞模型和治愈的患者 心肌梗塞。 这一假设的证实将 允许无创地确定范围和位置 室性心律失常患者的致心律失常心肌 心律失常，这可能有助于指导手术和导管 消融。