VECTOR MAPPING OF MYOCARDIAL ACTIVATION

室性快速性心律失常每年导致40万人死亡 在美国，这种现象涉及的机制和途径 心律失常还没有完全澄清，这已经 阻碍了治疗。申请人开发了一种技术， “矢量图”，可以准确地确定方向 正交法记录的心肌搏动扩散的研究 双极心电图仪。第一部分提出的实验 这一应用程序的使用将进一步完善这一新的方法。 这项技术与等时映射相结合，将 被用来描述传导和识别再入 实验性和临床性心肌梗死。项目1将 应对矢量技术的进一步发展 测绘技术；特别是检查瞬时 向量。这将为今后的实验奠定基础。 利用矢量映射。项目2将研究 将矢量制图与标准制图相结合的优势 脑室起始点定位的等时技术 心动过速。这可能说明向量映射 提高了心动过速标测的速度和准确性 导致其在探头标测中的广泛临床应用 心律失常手术中的室性心动过速。在项目中 3、矢量映射识别局部模式的能力 传导学将与标准技术结合使用 检查与纤维相关的均匀和非均匀各向异性 实验性心肌梗死与正常心肌的定位 人的心外膜。这些研究应该会增加 对异常者冲动传导细节的认识 并显示这种传导可能如何与 心律失常的发展。在项目4中，向量和 将使用等时映射来尝试识别 脑室内折返回路的解剖通路 心肌。希望除了改善 临床标测的速度、准确性和可用性 室性心动过速，这项资助中的研究将得到改进 对参与的途径和机制的理解 折返性心律失常并导致更好的方向 心律失常手术与替代治疗方法的选择 接近了。

Ventricular tachyarrhythmias result in 400,000 deaths annually in the U.S. The mechanisms and pathways involved in such arrhythmias have not been totally clarified and this has hampered therapy. The applicant has developed a technique, "vector mapping", which can accurately determine the direction of myocardial impulse spread by summing orthogonally recorded bipolar electrograms. Experiments proposed in the first portion of this application will further refine this new methodology. This technique in combination with isochronal mapping will then be used to characterize conduction and identify reentry in experimental and clinical myocardial infarction. Project 1 will deal with the further technical development of the vector mapping technique; specifically examining instantaneous vectors. This will lay the ground work for future experiments utilizing vector mapping. Project 2 will examine the advantages of combining vector mapping with standard isochronal techniques in localizing sites of origin of ventricular tachycardia. This may demonstrate that vector mapping improves the speed and accuracy of tachycardia mapping and lead to its widespread clinical use in probe mapping of ventricular tachycardia during arrhythmia surgery. In Project 3, the ability of vector mapping to identify patterns of local conduction will be used in combination with standard techniques to examine uniform and non-uniform anisotropy related to fiber orientation in experimental myocardial infarction and normal human epicardium. These studies should increase the understanding of the details of impulse conduction in abnormal cardiac muscle and show how such conduction may be related to the development of arrhythmias. In Project 4, vector and isochronal mapping will be employed in an attempt to identify the anatomic pathways of reentrant circuits in ventricular myocardium. It is hoped that in addition of improving the speed, accuracy and availability of clinical mapping of ventricular tachycardia, the studies in this grant will improve the understanding of the pathways and mechanisms involved in reentrant arrhythmias and lead to the better direction of arrhythmia surgery and selection of alternative therapeutic approaches.