室壁瘤相关室性心动过速的解剖基质特点  

Characteristics of arrhythmogenic substrate of ventricular aneurysm-related ventricular tachycardia

作　　者：宋伟[1] 刘长城[1] 王粮山 胡晖[1] 于洋[1] 顾承雄[1] Song Wei;Liu Changcheng;Wang Liangshan;Hu Hui;Yu Yang;Gu Chengxiong(Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京安贞医院心脏外科,北京100029

出　　处：《中华实验外科杂志》2019年第4期679-681,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金(81370436).

摘　　要：目的探讨室壁瘤相关室性心动过速的解剖基质的电生理特点。方法左侧开胸小切口冠脉结扎法建立猪心肌梗死后室壁瘤的疾病模型,使用三维电解剖标测系统同时在左心室心内膜-心室外膜行基质标测,记录并分析异常电位,定位室速的解剖基质。结果16只实验猪建模6周后10只伴典型室壁瘤形成,7只可诱发室壁瘤相关室速。心内膜和心外膜平均获取的标测点数分别为(319±45)个和(358±52)个。心内膜和心外膜低电压区面积分别为(28.85±4.36) cm^2和(24.26±4.64) cm^2,并且低电压区面积具有良好的相关性(r=0.92)。电解剖标测的异常电位大多定位在室壁瘤边缘区。结论室壁瘤相关室速的解剖基质多定位于室壁瘤边缘区,且具有全层心肌分布的三维结构特点。Objective To elucidate electrophysiologic characteristics of arrhythmogenic substrate in ventricular aneurysm-related ventricular tachycardia (VT). Methods Postinfarction left ventricular aneurysm (LVA) was developed by minimally invasive ligating coronary artery via left chest. Substrate mapping using 3D electroanatomic mapping system was performed on the endo-epicardium of left ventricle. Abnormal potentials were recorded and analysed to locate the arrhythmogenic substrate. Results Among 16 pigs, 10 suffered from LVA after 6 weeks of myocardial infarction, and 7 of the 10 pigs were induced LVA-related VT. The mapped points from endocardium and eipcardium were 319±45 and 358±52. The low-voltage area from endocardium and eipcardium were (28.85±4.36) cm^2 and (24.26±4.64) cm^2 with good correlation (r=0.920). And the abnormal potentials were majorly located in the border zone of LVA. Conclusion The arrhythmogenic substrates mainly located in the border zone of LVA with the characteristics of 3D nature in full-thickness myocardium.

关 键 词：心肌梗死 室壁瘤 室性心动过速 基质标测 

分 类 号：R732.1[医药卫生—肿瘤] R541.7[医药卫生—临床医学]