【摘要】：目的觀察三維電激動(dòng)標(biāo)測(cè)技術(shù)在心臟再同步化治療(CRT)無(wú)反應(yīng)擴(kuò)張型心肌病患者治療中的指導(dǎo)作用。方法選擇CRT無(wú)反應(yīng)的擴(kuò)張型心肌病患者22例,均行三維電激動(dòng)標(biāo)測(cè)檢查判斷左室電激動(dòng)最延遲部位;行冠狀靜脈竇逆行造影觀察激動(dòng)最延遲部位附近血管情況。17例激動(dòng)最延遲部位附近有血管且無(wú)畸形,選擇經(jīng)冠狀靜脈竇途徑植入左室導(dǎo)線;3例激動(dòng)最延遲部位附近無(wú)血管、2例血管畸形,選擇經(jīng)房間隔或室間隔穿刺途徑于激動(dòng)最延遲部位植入左室心內(nèi)膜導(dǎo)線。分別于手術(shù)前及術(shù)后1、3、6個(gè)月對(duì)患者心功能及左室同步性進(jìn)行評(píng)價(jià)。結(jié)果術(shù)后1、3、6個(gè)月,22例患者心功能指標(biāo)(紐約心臟病協(xié)會(huì)心功能分級(jí)、6 min步行距離、左室射血分?jǐn)?shù)、二尖瓣反流程度、左室收縮末期容積)及左室同步性評(píng)價(jià)指標(biāo)(室間機(jī)械延遲、左室內(nèi)最晚收縮-最早收縮達(dá)峰時(shí)間、左室12節(jié)段達(dá)峰時(shí)間標(biāo)準(zhǔn)差)與術(shù)前比較,P均0.05;術(shù)后3個(gè)月與術(shù)后1個(gè)月比較,P均0.05;術(shù)后6個(gè)月與術(shù)后1、3個(gè)月比較,P均0.05。結(jié)論三維電激動(dòng)標(biāo)測(cè)技術(shù)可準(zhǔn)確判斷CRT無(wú)反應(yīng)擴(kuò)張型心肌病患者左室電激動(dòng)最延遲部位,進(jìn)而選擇最佳途徑植入左室導(dǎo)線,提高患者對(duì)CRT的反應(yīng)性。
[Abstract]:Objective to observe the guiding effect of three dimensional electrokinetic mapping on cardiac resynchronization in patients with (CRT) nonreactive dilated cardiomyopathy. Methods Twenty-two patients with dilated cardiomyopathy without CRT were selected and the most delayed sites of left ventricular electrical stimulation were determined by three-dimensional electrokinetic mapping. Coronary sinus retrograde angiography was performed to observe the vascularity near the most delayed part of the coronary vein. In 17 cases, there was no malformation near the most delayed part, and the left ventricular lead was implanted through the approach of coronary sinus. In 3 cases, there was no blood vessel near the most delayed site, and 2 cases of vascular malformation. Transatrial septal or ventricular septal puncture was used to implant the left ventricular endocardial wire at the most delayed part of the agitation. Heart function and left ventricular synchrony were evaluated before operation and 1 and 6 months after operation. Results the cardiac function indexes of 22 patients (New York Heart Association cardiac function classification, 6 min walking distance, left ventricular ejection fraction, mitral regurgitation degree) were found 1 and 6 months after operation. The left ventricular end-systolic volume (LVEV) and left ventricular synchronism (LVL) were compared with those before operation (P < 0.05), including the left ventricular mechanical delay, the earliest peak systolic time and the left ventricular 12-segment peak time standard deviation. 3 months after operation compared with 1 month after operation, P 0.05, 6 months after operation compared with 1, 3 months after operation, P 0.05. Conclusion Three-dimensional electrokinetic mapping technique can accurately determine the most delayed site of left ventricular electrical stimulation in patients with CRT non-reactive dilated cardiomyopathy, and then select the best way to implant left ventricular conductors to improve the response of patients to CRT.
【作者單位】： 安徽醫(yī)科大學(xué)附屬省立醫(yī)院;
【基金】：安徽省科技攻關(guān)項(xiàng)目(1301042210)
【分類號(hào)】：R542.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前7條

1 梁延春;于海波;孫毅;金志清;許國(guó)卿;付柳靜;李世倍;王祖祿;韓雅玲;;電生理標(biāo)測(cè)冠狀靜脈竇分支最延遲電激動(dòng)處植入左室導(dǎo)線行心臟再同步化治療[J];中國(guó)心臟起搏與心電生理雜志;2012年03期

2 唐蔚波;心臟病常見的檢查技術(shù)[J];家庭醫(yī)學(xué);1996年23期

3 閻強(qiáng);管棟梁;;第二講 心電圖波形的產(chǎn)生原理[J];中國(guó)農(nóng)村醫(yī)學(xué);1986年03期

4 王立群;;心電圖的形成原理[J];心電圖雜志(電子版);2013年03期

5 尹松林,寧新寶;心電圖磁帶錄放儀試制成功[J];江蘇醫(yī)藥;1981年01期

6 閻強(qiáng);管棟梁;;第一講 心臟的自律傳導(dǎo)系統(tǒng)[J];中國(guó)農(nóng)村醫(yī)學(xué);1986年02期

7 ;[J];;年期

相關(guān)博士學(xué)位論文 前1條

1 雷森;頻譜分析在房顫中的應(yīng)用[D];北京協(xié)和醫(yī)學(xué)院;2012年

，

本文編號(hào)：2335773