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定量分析心肌梗死后室性心动过速折返环内传导减慢的持续时间

Quantitative analysis of the duration of slow conduction in the reentrant circuit of ventricular tachycardia after myocardial infarction
Li Y.-G., Wang Q.-S., Israel C.W., Gronefeld G., Lu S.-B., Ehrlich J.R., Hohnloser S.H.   |   2009/5/29 18:39:58 
Journal of Cardiovascular Electrophysiology, 2008   |   Volume 19, Issue 9  |   打印| 推荐给好友
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Quantitative Analysis of the Reentrant Circuit of Ventricular Tachycardia. Background: Few data are available to define the circuits in ventricular tachycardia (VT) after myocardial infarction and the conduction time (CT) through the zone of slow conduction (SCZ). This study assessed the CT of the SCZ and identified different reentrant circuits. Methods: During VTs, concealed entrainment (CE) was attempted. The SCZ was identified by a difference between postpacing interval (PPI) and VT cycle length (VTcl) ≤30 ms. Since the CT in the normally conducting part of the VT circuit is constant during VT and CE, a CE site within the reentrant circuit with (S-QRS)/PPI ≥ 50% was classified as an inner reentry in which the entire circuit was within the scar, and a CE site with (S-QRS)/PPI < 50% as a common reentry in which part of the circuit was within the scar and part out of the scar. Results: CE was achieved in 20 VTs (12 patients). Six VTs (30%) with a (S-QRS)/PPI ≥50% were classified as inner reentry and 14 VTs (70%) with a (S-QRS)/PPI <50% during CE mapping as common reentry. The EG-QRS interval (308 ± 73 ms vs 109 ± 59 ms, P < 0.0001) was significantly longer and the incidence of systolic potentials higher (4/6 vs 0/12, P < 0.001) in the inner reentry group. For the 14 VTs with a common reetry, the CT of the SCZ was 348 ± 73 ms, while the CT in the normal area was 135 ± 50 ms. Conclusion: According to the proposed classification, 30% of VTs after myocardial infarction had an entire reentrant circuit within the scar. In VTs with a common reentrant circuit, the CT of the SCZ is approximately four times longer than the CT in the normal area, accounting for more than 70% of VTcl. © 2008 Wiley Periodicals, Inc.
Correspondence Address: Li, Y.-G.; Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University, 200092 Shanghai, China; email: drliyigang@yahoo.com.cn 
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慢性心衰诊治:规范中求突破
黄峻
2012-2-1
南京医科大学第一附属医院
房颤治疗:手段渐趋丰富 新型治疗药物不断涌现 非药物治疗备受关注
马长生
2012-2-1
首都医科大学附属北京安贞医院
注重老年人群特征 优化管理

刘梅林
2012-2-1
北京大学第一医院老年内科

 

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