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|本期目录/Table of Contents|

起搏法定位不同类室速起源点正确性的实验研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2001年第6期
页码:
430-432
栏目:
论著
出版日期:
2001-11-01

文章信息/Info

Title:
Experimental study on the accuracy of locating the origins of various ventricular tachycardia by pacing
作者:
何　勇;  杜日映;  郑强荪;  高敏娟;  王　毅
第四军医大学唐都医院心血管内科, 陕西西安710038
Author(s):
HE Yong ;  DU Ri-ying ;  ZHENG Qiang-sun;  GAO Min-jun;  WANG Yi
Departerment of Cardiology, Tangtu Hospital, Fourth Military Medical University, Xi’an shaanxi 710038, China
关键词:
起搏标测;  心肌梗塞;  室性心动过速;  狗
Keywords:
pacing map;  myocardial infarction;  ventricular tachycardia;  dog
分类号:
R540.4
DOI:
-
文献标识码:
A
摘要:
目的 探讨起搏法定位不同类室性心动过速(VT ) 起源点的的正确性。方法 犬10 条, 记录心室7 位点心外膜、肌层及内膜下层起搏心电图(ECG) , 结扎冠状动脉前降支中段及吻合侧支, 并记录原位点各层起搏ECG, 与结扎前对照。结果 ① 两者起搏ECG 差异显著; ② 结扎前各位点及各层次起搏ECG 变化明显; ③ 梗死区及其周边位点可出现相似的起搏ECG 且各层次起搏ECG 变化不明显。结论 ① 起搏法标测特发性VT 起源点正确性较高; ②起搏法标测心梗后VT 起源点的正确性不高; ③ 体表ECG 定位心梗后VT 起源点的可靠性亦较差; ④特发性VT体表心电图判断V T 起源点的规律不适用于心梗后VT。
Abstract:
AIM To investigate the accuracy of locating the origins of various ventricular tachycardia (VT ) by pacing. METHODS the pacemaker ECGs were recorded on 21 sites of which were 7 in the epicardium , 7 in the myocardium and 7 in the endocardium , in each of the 10 dogs tested,and the results were compared with those of the same sites obtained after the anterior interventricular branch of left coronary artery and anastomotic branch were ligated. RESULTS It was found that the differences between these two groups of the pacemaker ECGs were marked. The pacemaker ECGs on all the sites of different layers were markedly different from one another before the ligation . However, the pacemaker ECGs on the sites in and around the infarcted zone were similar, and so were those on the different layers of one site. CONCLUSION The localization of the origin of idiopathicVT by pacing was fairly accurate. On the contrary, the localization of the origin of VT after myocardial infarction by pacing was not accurate enough, and neither was that by the surface ECG. The regulation for locating the origins in idiopathic VT by surface ECG is not applicable to VT after myocardial infarction.

参考文献/References

[1] Klein LS, Shih HT, Zipes DP, et al. Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease[J]. Circulation, 1992, 85 (5) : 1666.

[2] Chen YJ , Chen SA , Tai GT, et al. Radiofrequence ablation of idiopathic left ventricular tachycardia with changing ECG morphology[J]. Pacing Clin Electrophysiol, 1998, 21 (8) : 1668.

[3] Kamakura S, Shimizu W , Matsuo K, et al. Localization of optimal ablation site of idiopathic ventricular tachycardia from right and left ventricular outflow tract by body surface ECG[J]. Circulation, 1998, 98 (15) : 1525.

[4] Lin JL , Wilber DJ , Du D, et al. Localization of break through site of canine monomorphic ventricular tachycardia by pacemapping, A vectorial approach [J]. Circulation, 1991, 84 (3) : 1319.

[5] Gonska BD, Cao K, Schaumann A , et al. Catheter ablation of ventricular tachycardia in 136 patients with coronary artery disease ; results and long-term follow-up [J]. J Am Coll Cardiol,1994, 24 (6) : 1506.

[6] 杜日映, 侯应龙, 李公信. 体表心电图在判断室性心动过速起源点的意义[J]. 中华心血管病杂志, 1993, 21 (6) : 376.

备注/Memo

备注/Memo:
收稿日期：2000-08-31.
更新日期/Last Update: 2001-11-01