实验性心肌梗塞心室晚电位食道及心外膜实时记录对比研究  

A Comparative study of Ventricular Late Potentials Recorded on Esophagus and Epicardium in Experimental Myocardial Infarction

作　　者：赵宽[1] 侯晓平[2] 刘惠亮[2] 贾广兴[3] 阎志荣 

机构地区：[1]空军总医院老年病科 [2]空军总医院急诊科 [3]空军总医院动物实验室

出　　处：《空军总医院学报》1992年第3期125-128,共4页Journal of General Hospital of Air Force,PLA

摘　　要：实验性急性心肌梗塞早期30只犬,用改良的电极端弯曲可控导管,经食道实时记录心室晚电位(ESO-VLPs),与心外膜梗塞区实时记录心室晚电位(IZ-VLPs)对比研究结果:窦性心律时IZ-VLPs阳性76.6％;ESO-VLPs阳性70％,其敏感性、特异性及预测值分别为78.3％、57.1％及85.7％。程序心室刺激诱发持续性室速(VTs)9例,室颤(VF)11例。IZ-VLPs阳性和ESO-VLPs阳性犬诱发VTS/VF的预测值为78.3％VS、81％(P>0.05),IZ-VLPs阴性和ESO-VLPs阴性未诱发VTS/VF的预测值为71.4％VS、66.6％(P>0.05),表明食道实时记录心室晚电位是可行的。Animal experiments on thirty dogs were performed to study the early-stage of myocar-dial infarction, An esophageal catheter with adjustable electrode poles was used to record the Esophageal Ventricular Late potentials (ESO-VLPS), and to improve the signal-to-noise ratio during measurements. Comparing with the result obtained from monitoring the ventricular late potentials of the infarction zone of epicardium (or IZ-VLPS), it has demonstrated that, first, during sinus rhythm the positive rates of IZ-VLPS and ESO-VLPS were 76.6% and 70%; the sensitivity, specificity and the predictive value of ESO-VLPs were 78.3%, 57.1% and 85.7% respectively.Secondly, by using a programmed ventricular stimulator to induce sustained Ventricular Tachycardia (VTs, nine cases) and Ventricular Fibrillation (VF, elevan cases), the positive predictive value for induced VTs/VF in IZ-VLPs with ESO-VLPs were 78.3% VS. 81% (P>0.05) and the negative predictive value for non-induced VTs/VF in IZ-VLPs with ESO-VLPS were 71.4% VS. 66.6%(P>0.05). It has also shown that the microvolt-level signal from a delayed ventricular activation could be detected reliably on the esophagus surface.

关 键 词：实验性心肌梗塞 心室晚电位 食管实时记录 心外膜实时记录 体表信号平均心电图 持续性实速 持续性主颤 

分 类 号：R542.22[医药卫生—心血管疾病]