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|本期目录/Table of Contents|

经食管信号平均心电图记录窦房结电图的研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第6期
页码:
684-688
栏目:
临床研究
出版日期:
2007-12-20

文章信息/Info

Title:
Experimental and clinical study of sinus node electrogram by transesophageal signal averaging technique
作者:
丁世芳; 郭赤; 马大波
广州军区武汉总医院心内科,湖北 武汉 430070
Author(s):
DING Shi-fang;  GUO Chi;  MA Da-bo
Division of Cardiovascular Diseases, Wuhan General Hospital, Wuhan 430070, Hubei, China
关键词:
窦房结电图; 信号叠加; 食管导管
Keywords:
sinus node electrogram;  signal averaging;  transesophageal catheter
分类号:
R540.41
DOI:
-
文献标识码:
A
摘要:
目的 探讨无创性经食管信号平均技术直接记录窦房结电位（SNP）的方法。 方法 采用自制三导心电微电位检测仪对256例窦房结功能正常者进行检测，其中男142例，女114例，年龄10~74(44.2±12.4)岁。将食管导联的信号放大（增益达到100 μV/cm）、滤波（0.1~50)Hz，16位模/数（A/D）转换，系统采样频率2 kHz，对食管SNP进行信号平均，并通过同步信号平均对人食管和心内膜所记录的SNP，犬食管和心外膜所记录的SNP进行分析研究。 结果 记录到食管SNP 189例（74%），所测信号平均食管SNP为P波前的低幅、低频波，可见有2种形态：园顶型（60%）和上斜型（40%）；窦房传导时间为(83.3±26.7)ms，分布范围为(23~118)ms；波幅为(3.5~27.7)μV；dv/dt为(0.43~1.93)mV/s。 结论 在适当滤波、高增益和抗基线漂移技术条件下，利用经食管信号平均技术，大多数窦房结功能正常的患者可直接记录到食管SNP。
Abstract:
AIM To develop a noninvasive transesophageal signal averaging technique for direct recording of sinus node electrogram. METHODS Sinus node electrograms were recorded by conventional transesophageal technique from 256 patients (142 male and 114 female, aged from 10 to 74 (mean 44.2±12.4). The signals from lead I, surface averaged lead and esophagus averaged lead were amplified (up to 100 μV/cm), filtered (0.1-50）Hz, AD converted to 16bit accuracy at a sampling rate of 2 kHz and averaged by using the threechannel lownoise amplifier. To verify sinus node potentials recorded by esophageal lead, electric activities of esophagus /sinus node area and right atrium were simultaneously recorded in humans and in dogs by intracardiac direct record method. RESULTS The signal averaged esophageal sinus node potentials were deflections of lowamplitude and lowfrequency preceding the P wave. Two morphologies, the domed wave (114 of 189 patients, 60%) and the smooth upstroke slope (75 of 189 patients, 40%) were seen. The directly recorded sinoatrial conduction time was （83.3±26.7）ms, ranging from 23 to 118 ms, amplitude was (3.5-27.7)μV and dv/dt was (0.43-1.93)mV/s. The sinoatrial conduction time recorded by the transesophageal catheter technique was well comparable to that (80.4±18.1) ms recorded by the transvenous catheter method. CONCLUSION Signal averaged sinus node electrogram can record sinus rhythm in most patients with normal sinus node function. Poper filter settings, high amplification and antidrift technique are important in recording signal averaged esophageal sinus node electrogram.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2006-08-01.通讯作者：丁世芳，Email:Dsfmd@yahoo.com.cn
更新日期/Last Update: