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首页> 美国卫生研究院文献>other >Usefulness of Ventricular Endocardial Electric Reconstruction from Body Surface Potential Maps to Noninvasively Localize Ventricular Ectopic Activity in Patients
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Usefulness of Ventricular Endocardial Electric Reconstruction from Body Surface Potential Maps to Noninvasively Localize Ventricular Ectopic Activity in Patients

机译：从体表电位图到无创定位患者心室异位活动的心室心内膜电重建的有用性

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As radio frequency (RF) catheter ablation becomes increasingly prevalent in the management of ventricular arrhythmia in patients, an accurate and rapid determination of the arrhythmogenic site is of important clinical interest. The aim of this study was to test the hypothesis that the inversely reconstructed ventricular endocardial current density distribution from body surface potential maps (BSPMs) can localize the regions critical for maintenance of a ventricular ectopic activity. Patients with isolated and monomorphic premature ventricular contractions (PVCs) were investigated by noninvasive BSPMs and subsequent invasive catheter mapping and ablation. Equivalent current density (CD) reconstruction (CDR) during symptomatic PVCs was obtained on the endocardial ventricular surface in 6 patients (4 men, 2 women, years 23–77), and the origin of the spontaneous ectopic activity was localized at the location of the maximum CD value. Compared with the last (successful) ablation site (LAS), the mean and standard deviation of localization error of the CDR approach were 13.8 mm and 1.3 mm, respectively. In comparison, the distance between the LASs and the estimated locations of an equivalent single moving dipole (SMD) in the heart was 25.5 ± 5.5 mm. The obtained CD distribution of activated sources extending from the catheter ablation site also showed a high consistency with the invasively recorded electroanatomical maps. The noninvasively reconstructed endocardial CD distribution is suitable to predict a region of interest containing or close to arrhythmia source, which may have the potential to guide RF catheter ablation.
机译：随着射频（RF）导管消融在患者室性心律不齐的管理中变得越来越普遍，准确，快速确定心律不齐的部位具有重要的临床意义。这项研究的目的是检验以下假设，即从体表电位图（BSPM）反向重建的心室心内膜电流密度分布可以定位对于维持心室异位活动至关重要的区域。通过无创BSPM以及随后的有创导管测绘和消融研究了孤立性和单形性室性早搏（PVC）患者。在6例患者（4例男性，2例女性，23-77岁）的心内膜表面获得了有症状PVC期间的等效电流密度（CD）重建（CDR），并且自发性异位活动的起源位于最大CD值。与最后一个（成功的）消融部位（LAS）相比，CDR方法的定位误差的平均值和标准偏差分别为13.8 mm和1.3 mm。相比之下，LAS与心脏中等效单动偶极子（SMD）的估计位置之间的距离为25.5±5.5 mm。从导管消融部位延伸得到的活化源的CD分布也与侵入性记录的电解剖图显示出高度一致性。无创重建的心内膜CD分布适合预测包含或接近心律不齐来源的目标区域，该区域可能具有引导RF导管消融的潜力。

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