Circulation:窦性心律传导异常点指导的室速的靶向消融

2019-10-24 梅梅 梅斯原创

准确和快速的识别最容易再起搏的瘢痕区域是指导室性心动过速(,简称室速,VT)射频消融的必要条件。研究人员前瞻性评估了窦性心律时,靶向心室激动传导分析所鉴定的减速带(DZ)进行的VT射频消融的预后。本研究招募了120位瘢痕相关的室速患者(中位年龄65岁[59-71],15%的女性,50%的非缺血性,中位射血分数为31%),共进行了144次射频消融。57%的患者既往进行过射频消融,59%的患者有心外膜

准确和快速的识别最容易再起搏的瘢痕区域是指导室性心动过速(,简称室速,VT)射频消融的必要条件。研究人员前瞻性评估了窦性心律时,靶向心室激动传导分析所鉴定的减速带(DZ)进行的VT射频消融的预后。

本研究招募了120位瘢痕相关的室速患者(中位年龄65岁[59-71],15%的女性,50%的非缺血性,中位射血分数为31%),共进行了144次射频消融。57%的患者既往进行过射频消融,59%的患者有心外膜接触史。

在基线心律期间进行了高密度绘图(心内膜 2518个点[1615-3752],心外膜 5049±2580个点),最后,每位患者确定了2±1个减速带,95%的患者的减速带与成功终止室速的点相同。靶向DZ的中位总射频时间为29min(21-38min)。12±10个月时,70%的患者未复发室速。总体存活率为87%。

一种新型的不依赖电压的高密度绘图显示器可在窦性心律中识别窦性心动过速的功能位点,并指导靶向射频消融,从而避免了广泛的射频消融的需要。基线节律时,传导拥堵的区域是预测的VT终止位点,为减速带是高度致心律失常、可作异位起搏点的推论提供了机制证据。

原始出处:



本文系梅斯医学(MedSci)原创编译,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1421791, encodeId=41731421e91de, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476265, encodeId=244914e6265b7, content=<a href='/topic/show?id=1abce558582' target=_blank style='color:#2F92EE;'>#窦性心律#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75585, encryptionId=1abce558582, topicName=窦性心律)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5e147265575, createdName=paperyu, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479756, encodeId=559b14e9756ed, content=<a href='/topic/show?id=a9ab4624280' target=_blank style='color:#2F92EE;'>#室速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46242, encryptionId=a9ab4624280, topicName=室速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5bbc7579990, createdName=124987e8m09暂无昵称, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374440, encodeId=28e73e4440b8, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Sat Oct 26 05:40:44 CST 2019, time=2019-10-26, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1421791, encodeId=41731421e91de, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476265, encodeId=244914e6265b7, content=<a href='/topic/show?id=1abce558582' target=_blank style='color:#2F92EE;'>#窦性心律#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75585, encryptionId=1abce558582, topicName=窦性心律)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5e147265575, createdName=paperyu, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479756, encodeId=559b14e9756ed, content=<a href='/topic/show?id=a9ab4624280' target=_blank style='color:#2F92EE;'>#室速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46242, encryptionId=a9ab4624280, topicName=室速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5bbc7579990, createdName=124987e8m09暂无昵称, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374440, encodeId=28e73e4440b8, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Sat Oct 26 05:40:44 CST 2019, time=2019-10-26, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1421791, encodeId=41731421e91de, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476265, encodeId=244914e6265b7, content=<a href='/topic/show?id=1abce558582' target=_blank style='color:#2F92EE;'>#窦性心律#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75585, encryptionId=1abce558582, topicName=窦性心律)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5e147265575, createdName=paperyu, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479756, encodeId=559b14e9756ed, content=<a href='/topic/show?id=a9ab4624280' target=_blank style='color:#2F92EE;'>#室速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46242, encryptionId=a9ab4624280, topicName=室速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5bbc7579990, createdName=124987e8m09暂无昵称, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374440, encodeId=28e73e4440b8, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Sat Oct 26 05:40:44 CST 2019, time=2019-10-26, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1421791, encodeId=41731421e91de, content=<a href='/topic/show?id=4bc865819d2' target=_blank style='color:#2F92EE;'>#消融#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65819, encryptionId=4bc865819d2, topicName=消融)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1a193676008, createdName=xiangyuzhou972, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476265, encodeId=244914e6265b7, content=<a href='/topic/show?id=1abce558582' target=_blank style='color:#2F92EE;'>#窦性心律#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75585, encryptionId=1abce558582, topicName=窦性心律)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5e147265575, createdName=paperyu, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1479756, encodeId=559b14e9756ed, content=<a href='/topic/show?id=a9ab4624280' target=_blank style='color:#2F92EE;'>#室速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46242, encryptionId=a9ab4624280, topicName=室速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5bbc7579990, createdName=124987e8m09暂无昵称, createdTime=Sat Oct 26 07:31:00 CST 2019, time=2019-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=374440, encodeId=28e73e4440b8, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bbc11488193, createdName=thm112988, createdTime=Sat Oct 26 05:40:44 CST 2019, time=2019-10-26, status=1, ipAttribution=)]
    2019-10-26 thm112988

    0

相关资讯

JACC:结构性心脏病经导管消融治疗室性心动过速的早期死亡率

在有瘢痕相关性VT接受RFCA治疗患者中,EM发生率为5%。表明临床状态较差的临床和手术变量(低LVEF、慢性肾脏疾病、VT风暴和不可融合的VT)和手术后VT复发可预测EM。

JACC:心脏结构正常室性心动过速的导管消融

近日,JACC杂志发布了室性心动过速(VT)导管消融的最新进展。

NEJM:室性心动过速患者使用导管消融优于抗心律失常药物

带有植入式心律转复除颤器(ICD)心肌梗死的幸存者尽管服用抗心律失常药物治疗,但发生复发性室性心动过速也非常频繁。解决这个问题最有效的管理方法是不确定的。原始出处:John L. Sapp,George A. Wells,Ratika Parkash,et al.Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic

ESC 2015:新版室性心律失常和心脏性猝死指南重要更新抢先速看

8月29日,ESC对室性心律失常和心脏性猝死指南进行了重要更新,新版指南最新发表在European Heart Journal和ESC网站,这是继2006年版欧洲/美国的欧洲指南最新更新。这一指南旨在预防室性心律失常患者心源性猝死的发生。1.DNA分析应作为中青年猝死者验尸报告中的一个基本组成 明确中青年猝死者的遗传因素情况有助于快速诊断猝死的原因,对防止亲属中再次发生猝死有益。指南的制

BMJ:延迟二次除颤治疗持续性VT/VF可增加患者的住院率

来自美国东部的一个卫生保健系统描述了第一和第二尝试除颤之间的时间间隔的趋势以及与此时间间隔与因持续性室性心动过速或心室颤动(VT / VF)而住院的患者结局之间的关系。

急性心梗伴室性心动过速 **药物是什么?

急性心肌梗死后并发持续性室性心动过速临床上并不少见,为避免引起急性期死亡,必须及时处理。那么,针对此病应采用哪种治疗方案?