Gerstenfeld E P, SippensGroenewegen A, Lux R L, Lesh M D
University of California, San Francisco, USA.
J Electrocardiol. 2000;33 Suppl:179-85. doi: 10.1054/jelc.2000.20307.
Atrial fibrillation is often initiated by atrial premature beats originating in the pulmonary veins. Non-invasive localization of these ectopic beats would be of significant value in guiding therapy. Body surface potential mapping was performed in nine patients undergoing invasive electrophysiologic study. Signals were recorded from 62 electrodes during pace mapping from each of the pulmonary veins. Optimal electrodes for localizing pulmonary vein activation were sequentially chosen. Seven optimal electrodes (6 anterior, 1 posterior) for recording ectopic atrial activation originating in the pulmonary veins were selected. The seven optimal electrode set performed better than the standard 9 electrode ECG at estimating the full body surface map (correlation 97 vs. 95.7%; p < 0.05). Seven optimally selected electrodes can estimate the body surface potential distribution during ectopic atrial activation orignating from the pulmonary veins. The ability of this electrode configuration to discriminate the site of origin of ectopic atrial beats requires prospective evaluation.
房颤常由起源于肺静脉的房性早搏引发。这些异位搏动的无创定位对指导治疗具有重要价值。对9例接受有创电生理研究的患者进行了体表电位标测。在对每条肺静脉进行起搏标测时，从62个电极记录信号。依次选择用于定位肺静脉激动的最佳电极。选择了7个用于记录起源于肺静脉的异位心房激动的最佳电极（6个在前，1个在后）。在估计全身体表图方面，这7个最佳电极组比标准的9电极心电图表现更好（相关性分别为97%和95.7%；p<0.05）。7个最佳选择的电极能够估计起源于肺静脉的异位心房激动期间的体表电位分布。这种电极配置鉴别异位心房搏动起源部位的能力需要前瞻性评估。
