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[心内心电图在心律失常诊断中的应用]

[The intracardiac electrocardiogram in the diagnosis of arrhythmias].

作者信息

Kozák M

机构信息

Interní kardiologická klinika FN Brno, pracovistĕ Bohunice.

出版信息

Vnitr Lek. 2002 Dec;48 Suppl 1:170-7.

Abstract

During the last 15 years in arrhythmology brisk development of the use of endocardial electrocardiograms (IECG) occurred. At first the objective was to describe the characteristics of the conduction system of the heart (recording of Hisogram), next assessment of pathological features of the conduction system (such as bradyarrhythmias), electric activation of the myocardium in existing arrhythmias with the outcome of the diagnosis and accurate localization of additional pathways in endocardial mapping. The next logical step reacting to knowledge of intracardial mapping was the development of new therapeutic methods--DC and subsequently radiofrequency ablation--non-pharmacological therapeutic antiarrhythmic approaches which are by now commonly used in electrophysiological catheterization laboratories of cardiological departments. Some contemporary pacemakers can also record intracardial atrial and ventricular IECG and make it possible to use additional antiarrhythmic stimulation. A dominant position is held by the IECG in implantable cardioverters-defibrillators where on the high standard recording of IECG a considerable proportion of detection and decision-making algorithms of this equipment is based. Recording IECG is an integral part of clinical arrhythmological practice from the diagnostic as well as therapeutic aspect.

摘要

在过去15年里,心内膜心电图(IECG)在心律失常学领域的应用迅速发展。起初,目的是描述心脏传导系统的特征(希氏束电图记录),接着是评估传导系统的病理特征(如缓慢性心律失常),分析现有心律失常时心肌的电激动情况,以进行诊断并在心内膜标测中准确定位附加通路。基于心内标测知识的下一个合理步骤是开发新的治疗方法——直流电消融以及随后的射频消融——这些非药物治疗性抗心律失常方法目前已在心脏病科的电生理导管实验室中普遍使用。一些当代起搏器也可以记录心内的心房和心室IECG,并使得额外的抗心律失常刺激成为可能。IECG在植入式心脏复律除颤器中占据主导地位,该设备的相当一部分检测和决策算法是基于IECG的高标准记录。从诊断和治疗角度来看,记录IECG是临床心律失常学实践不可或缺的一部分。

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