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[三维向量心电图预测心脏再同步治疗反应者]

[Three-dimensional vectorcardiography to predict CRT-responder].

作者信息

Koglek W, Brandl J, Oberbichler A, Schmidt K, Grimm G, Butter C

机构信息

2 Medizinische Abteilung, Landeskrankenhaus Klagenfurt, St.-Veiter-Strasse 47, 9020, Klagenfurt, Osterreich.

出版信息

Herzschrittmacherther Elektrophysiol. 2006;17 Suppl 1:I28-36. doi: 10.1007/s00399-006-1105-9.

Abstract

Cardiac resynchronization therapy (CRT) is an accepted treatment for congestive heart failure (NYHA III-IV), but a substantial number of patients show no response to therapy. LBB, QRS width and echocardiographic measurements are parameters for indication, but they are not valid to predict hemodynamic response. A new method based on vector ECG analysis can deliver additional information, such as: parts or areas with late excitation, and with slow or fast depolarization speed. Electrical excitation is a prerequisite for contraction; this leads to the hypothesis that areas with late electrical activation will contract later. Algorithms for analysis of the vector ECG (determination of the vector -- time, area and speed) may help to identify responders and non-responders.

摘要

心脏再同步治疗(CRT)是治疗充血性心力衰竭(纽约心脏协会III-IV级)的一种公认疗法,但相当多的患者对该疗法无反应。左束支传导阻滞、QRS波宽度和超声心动图测量是用于确定适应症的参数,但它们无法有效预测血流动力学反应。一种基于向量心电图分析的新方法可以提供额外信息,例如:晚激动的部位或区域,以及去极化速度慢或快的部位或区域。电激动是收缩的前提条件;由此产生一个假设,即电激活较晚的区域将较晚收缩。向量心电图分析算法(确定向量——时间、面积和速度)可能有助于识别反应者和无反应者。

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