BODY SURFACE LOCALIZATION OF QRS LATE POTENTIALS

室性心律失常是发病率的主要来源， 死亡率在这个国家。 药物治疗这些 心律失常通常是不成功的， 手术和导管技术来消除它们。 最近，信号平均心电图已被用于 显示在末端发生异常偏转， 室性心律失常患者的QRS波群; 这些被称为“晚电位”。“晚电位被认为 从传导缓慢的心肌的局部区域产生， 这也被认为是产生局部分馏 可直接记录在心脏表面上的电描记图。 的 碎裂电描记图的范围已被证明与 心律失常的风险，以及碎裂的位置 电描记图已被证明与 致瘤性心肌 以前检测晚电位的方法没有尝试 以确定它们在体表的位置。 初步研究 在这个实验室的心肌梗塞犬模型中， 已经提出，晚电位局限于一个连续的 胸部的区域。 该应用程序的主要假设是 晚电位的位置表明， 碎裂电图的心外膜位置和缓慢 传导，这反过来又可以指导消融治疗， 心律不齐 这一假设将在一只狗身上进行检验， 治愈的心肌梗死模型和治愈的 心肌梗死 证实这一假设将 允许非侵入性地确定 室性心动过速患者的致心律失常性心肌 心律失常，这可能有助于指导手术和导管 消融术

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.