BODY SURFACE LOCALIZATION OF QRS LATE POTENTIALS

室性心律失常是发病率和 这个国家的死亡率。这些疾病的药物治疗 心律失常通常是不成功的，人们对 外科手术和导管技术以消除它们。 最近，信号平均心电图法已被用于 演示在末端发生的异常变形 许多室性心律失常患者的QRS波群； 这就是所谓的“后发潜力”。迟来的潜力被认为是 起源于缓慢传导心肌的局部区域， 也被认为会产生局部化的分馏 可直接记录在心脏表面的电信号。这个 分离的电信号的范围已经被证明与 与心律失常的风险，以及分流的位置 已有研究表明，脑电图与脑电活动区域有关 致心律失常的心肌。 以前的检测延迟电位的方法没有尝试过 以确定它们在体表上的位置。初步研究 在本实验室建立的犬心肌梗死模型中 已经提出了晚电位局限于连续的 胸腔上的区域。这个应用程序的主要假设是 建议研究的是，晚电位的位置表明 分段性心电图和慢波的心外膜定位 传导，这反过来可以指导消融治疗 心律不齐。这一假设将在犬类身上进行检验 已愈的心肌梗死模型和已愈的患者 心肌梗死。这一假设的实证性将 允许非侵入性确定病变的范围和位置 室性心动过速患者致心律失常的心肌 心律失常，这可能有助于指导手术和导管 消融。

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.