基于心外膜标测的心房易颤性评估  

Assessment of atrial fibrillation inducibility based on epicardial mapping signals

作　　者：何凯悦 杨翠微[1,2,3] HE Kaiyue;YANG Cuiwei(Department of Electronic Engineering,Fudan University,Shanghai 200433,P.R.China;Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention of Shanghai,Shanghai 200093,P.R.China;Shanghai Engineering Research Center of Cardiac Electrophysiology,Shanghai 201318,P.R.China)

机构地区：[1]复旦大学电子工程系,上海200433 [2]上海市医学图像处理与计算机辅助手术重点实验室,上海200093 [3]上海心脏电生理工程技术研究中心,上海201318

出　　处：《生物医学工程学杂志》2020年第3期487-495,501,共10页Journal of Biomedical Engineering

基　　金：国家自然科学基金(61071004,81671777);上海市科技支撑项目(18441900900);上海市市级科技重大专项(2017SHZDZX01);上海工程技术研究中心项目(19DE2250800)。

摘　　要：心房颤动(简称:房颤)是临床上最常见的心律失常,可引起血流动力学改变、心力衰竭、脑卒中等并发症,严重影响着人类的生命健康。作为一种自身促进性疾病,房颤的治疗难度会随着病情恶化逐渐增加,早期预测和干预是遏止病情恶化的关键。基于此,本文通过控制乙酰胆碱静脉注射剂量,改变了5只杂交犬的心房易颤性,并尝试通过分析不同状态窦性心律下心房心外膜的电活动特性来评估心房易颤性。本文主要从心房激动间期变异性、心房最早激动点转移、心房激动时延变化、左右心房失步四个方面提出4项指标来研究心房的激动规律,并利用二元逻辑回归分析,将多项指标转化为房颤诱发成功概率,从而对窦性信号进行分类。分类的敏感性、特异性和准确率分别达到85.7%、95.8%和91.7%。实验结果表明,本文方法具有评估心房易颤性的能力,对房颤的提前预测和干预具有重要的临床意义。Atrial fibrillation(AF)is the most common arrhythmia in clinic,which can cause hemodynamic changes,heart failure and stroke,and seriously affect human life and health.As a self-promoting disease,the treatment of AF can become more and more difficult with the deterioration of the disease,and the early prediction and intervention of AF is the key to curbing the deterioration of the disease.Based on this,in this study,by controlling the dose of acetylcholine,we changed the AF vulnerability of five mongrel dogs and tried to assess it by analyzing the electrophysiology of atrial epicardium under different states of sinus rhythm.Here,indices from four aspects were proposed to study the atrial activation rule.They are the variability of atrial activation rhythm,the change of the earliest atrial activation,the change of atrial activation delay and the left-right atrial dyssynchrony.By using binary logistic regression analysis,multiple indices above were transformed into the AF inducibility,which were used to classify the signals during sinus rhythm.The sensitivity,specificity and accuracy of classification reached 85.7%,95.8%and 91.7%,respectively.As the experimental results show,the proposed method has the ability to assess the AF vulnerability of atrium,which is of great clinical significance for the early prediction and intervention of AF.

关 键 词：房颤 心外膜标测 电生理特性 二元逻辑回归 

分 类 号：R541.75[医药卫生—心血管疾病]