Torres Jose Luis, Shah Bindi K, Greenberg Richard M, Deger Florin Titus, Gerstenfeld Edward P
Temple University School of Medicine, Temple University Hospital, Philadelphia, PA 19140, USA.
J Interv Card Electrophysiol. 2010 Oct;29(1):11-6. doi: 10.1007/s10840-010-9488-2. Epub 2010 May 12.
We hypothesized that in patients with left ventricular dysfunction undergoing implant of a biventricular ICD, the local dominant frequency during early induced ventricular fibrillation would be higher at an epicardial left ventricular position compared to an endocardial right ventricular position.
Patients undergoing implant of a biventricular ICD were studied. During ventricular fibrillation induction, bipolar electrograms were recorded from leads at an epicardial left ventricular position and an endocardial right ventricular position. Overlapping 2-s fast Fourier transforms were obtained for 6 s of ventricular fibrillation. The dominant frequency and organizational index were compared.
Thirty-four patients (20 men, age 64 ± 11 years) underwent 57 inductions of ventricular fibrillation. Eighteen patients had non-ischemic dilated cardiomyopathy and 16 had ischemic dilated cardiomyopathy. The dominant frequency was higher at a lateral epicardial left ventricular position than an apical endocardial right ventricular position in 18 patients with non-ischemic dilated cardiomyopathy (LV epicardial 5.34 ± 0.37 Hz, RV endocardial 5.09 ± 0.41 Hz, p < 0.001), but not in 16 patients with ischemic dilated cardiomyopathy (LV epicardial 4.99 ± 0.57 Hz, RV epicardial 4.87 ± 0.65 Hz, p = 0.094).
In patients with non-ischemic dilated cardiomyopathy, there is a dominant frequency gradient during early ventricular fibrillation induced at ICD testing from the lateral left ventricular epicardium to the apical right ventricular endocardium.
我们假设，在接受双心室植入式心律转复除颤器（ICD）的左心室功能不全患者中，与心内膜右心室位置相比，早期诱发性心室颤动期间的心外膜左心室位置的局部主导频率会更高。
对接受双心室ICD植入的患者进行研究。在诱发心室颤动期间，从心外膜左心室位置和心内膜右心室位置的导联记录双极电图。对6秒的心室颤动获取重叠的2秒快速傅里叶变换。比较主导频率和组织指数。
34例患者（20例男性，年龄64±11岁）接受了57次心室颤动诱发。18例患者患有非缺血性扩张型心肌病，16例患有缺血性扩张型心肌病。在18例非缺血性扩张型心肌病患者中，心外膜左心室外侧位置的主导频率高于心内膜右心室心尖位置（左心室心外膜5.34±0.37Hz，右心室心内膜5.09±0.41Hz，p<0.001），但在16例缺血性扩张型心肌病患者中则不然（左心室心外膜4.99±0.57Hz，右心室心外膜4.87±0.65Hz，p=0.094）。
在非缺血性扩张型心肌病患者中，在ICD测试期间早期诱发的心室颤动期间，从左心室心外膜外侧到右心室心内膜心尖存在主导频率梯度。
