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生物电池信号可在体外预测心肌损伤的形成及深度。

Bio-battery signal predicts myocardial lesion formation and depth in vitro.

作者信息

He D S, Sharma P, Wang X, Bosnos M, Marcus F I

机构信息

University of Arizona, Tucson, USA.

出版信息

J Interv Card Electrophysiol. 1999 Mar;3(1):69-77. doi: 10.1023/a:1009883825242.

DOI:10.1023/a:1009883825242
PMID:10354979
Abstract

AIMS

The aim of this study was to determine if the bio-battery signal can predict myocardial lesion formation and depth.

METHODS

Fresh bovine ventricular myocardium was immersed in a temperature-controlled bath of circulating blood. RF energy was delivered with a custom generator to a catheter electrode. RF energy, electrode temperature, bio-battery signal and tissue impedance were displayed and recorded. A copper return plate was placed in the bath.

RESULTS

When 50 volts of constant RF energy was terminated at a 20, 40, or 60% decline from the maximum bio-battery signal, the lesion depth was 4 +/- 0.4 mm. When RF energy application was terminated later, at a point characterized by a brief change of slope of the bio-battery signal, the lesions measured 7.8 +/- 1.4 mm in depth. This "bump" occurred before a rapid impedance rise.

CONCLUSION

The depth of lesions created at the "bump" point was almost two-fold deeper than those at the termination points of 20, 40 and 60% bio-battery decrease (p = 0.0001). When RF energy was terminated at the rapid impedance rise the lesions were similar in depth, 8.2 +/- 0.9 mm, to those obtained when RF energy was stopped at the "bump" (p = 0.28). The bio-battery signal provides a unique marker that might be useful to obtain maximum lesion depth while avoiding rapid impedance rise.

摘要

目的

本研究旨在确定生物电池信号是否能够预测心肌损伤的形成及深度。

方法

将新鲜牛心室心肌浸入温度可控的循环血液浴槽中。通过定制发生器向导管电极输送射频能量。显示并记录射频能量、电极温度、生物电池信号及组织阻抗。在浴槽中放置一块铜制回路板。

结果

当50伏恒定射频能量在生物电池信号最大值下降20%、40%或60%时终止施加,损伤深度为4±0.4毫米。当射频能量施加在生物电池信号斜率短暂变化的点之后终止时,测得损伤深度为7.8±1.4毫米。这种“凸起”出现在阻抗快速上升之前。

结论

在“凸起”点产生的损伤深度几乎是生物电池信号下降20%、40%和60%时终止施加射频能量所产生损伤深度的两倍(p = 0.0001)。当在阻抗快速上升时终止射频能量施加,损伤深度与在“凸起”点停止射频能量施加时相似,为8.2±0.9毫米(p = 0.28)。生物电池信号提供了一个独特的标志物,可能有助于在避免阻抗快速上升的同时获得最大损伤深度。

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本文引用的文献

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Pacing Clin Electrophysiol. 1996 Jul;19(7):1042-8. doi: 10.1111/j.1540-8159.1996.tb03411.x.
2
Radiofrequency catheter ablation of idiopathic left ventricular tachycardia guided by a Purkinje potential.以浦肯野电位为导向的特发性左心室心动过速的射频导管消融术
Circulation. 1993 Dec;88(6):2607-17. doi: 10.1161/01.cir.88.6.2607.
3
Comparison of in vivo tissue temperature profile and lesion geometry for radiofrequency ablation with a saline-irrigated electrode versus temperature control in a canine thigh muscle preparation.
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Circulation. 1995 Apr 15;91(8):2264-73. doi: 10.1161/01.cir.91.8.2264.
4
Temperature measurement as a determinant of tissue heating during radiofrequency catheter ablation: an examination of electrode thermistor positioning for measurement accuracy.作为射频导管消融术中组织加热决定因素的温度测量:关于电极热敏电阻定位对测量准确性的研究。
J Cardiovasc Electrophysiol. 1995 Apr;6(4):268-78. doi: 10.1111/j.1540-8167.1995.tb00399.x.
5
Radiofrequency coagulation of ventricular myocardium: improved prediction of lesion size by monitoring catheter tip temperature.心室心肌的射频消融:通过监测导管尖端温度改善对损伤大小的预测
Eur Heart J. 1989 Nov;10(11):972-84. doi: 10.1093/oxfordjournals.eurheartj.a059422.
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Observations on electrode-tissue interface temperature and effect on electrical impedance during radiofrequency ablation of ventricular myocardium.心室心肌射频消融过程中电极-组织界面温度及对电阻抗影响的观察
Circulation. 1990 Sep;82(3):1034-8. doi: 10.1161/01.cir.82.3.1034.
7
Diagnosis and cure of the Wolff-Parkinson-White syndrome or paroxysmal supraventricular tachycardias during a single electrophysiologic test.在单次电生理检查中对预激综合征或阵发性室上性心动过速的诊断与治疗
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