Suzuki Atsushi, Shiga Tsuyoshi, Nakai Kenji, Futagawa Keisuke, Matsuyama Yuko, Shoda Morio, Kasanuki Hiroshi, Hagiwara Nobuhisa
Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
J Electrocardiol. 2010 Nov-Dec;43(6):706-12. doi: 10.1016/j.jelectrocard.2010.07.001. Epub 2010 Aug 17.
The effectiveness of cardiac resynchronization therapy (CRT) in preventing sudden cardiac death is controversial. Epicardial left ventricular pacing reverses the direction of activation of the left ventricular wall from the epicardium to the endocardium. We evaluated whether the interlead difference between T-peak to T-end (Tp-e) intervals determined by a 187-channel repolarization interval-difference mapping electrocardiograph (187-ch RIDM-ECG) is related to the occurrence of ventricular tachyarrhythmia requiring implantable cardioverter-defibrillator (ICD) therapy in heart failure patients receiving CRT with a defibrillator (CRT-D).
Repolarization interval-difference mapping electrocardiograph (187-channel) was performed on 61 patients who received CRT-D. Twenty-one patients experienced appropriate ICD therapy. The interlead difference between corrected recovery time intervals was not significantly different between patients with and without appropriate ICD therapy (98 ± 24 milliseconds versus 88 ± 24 milliseconds). The interlead difference between corrected Tp-e intervals was significantly higher in patients with appropriate ICD therapy than in those without (88 ± 22 milliseconds versus 59 ± 23 milliseconds, P < .001).
The interlead difference between corrected Tp-e intervals determined by 187-ch RIDM-ECG may be related to appropriate ICD therapy in heart failure patients receiving CRT-D.
心脏再同步治疗（CRT）预防心源性猝死的有效性存在争议。心外膜左心室起搏可使左心室壁的激动方向从心外膜转为心内膜。我们评估了通过187通道复极间期差异标测心电图（187-ch RIDM-ECG）测定的T波峰至T波末（Tp-e）间期的导联间差异是否与接受带除颤器的CRT（CRT-D）的心力衰竭患者发生需要植入式心律转复除颤器（ICD）治疗的室性快速心律失常有关。
对61例接受CRT-D的患者进行了复极间期差异标测心电图（187通道）检查。21例患者接受了适当的ICD治疗。接受和未接受适当ICD治疗的患者校正恢复时间间期的导联间差异无显著差异（98±24毫秒对88±24毫秒）。接受适当ICD治疗的患者校正Tp-e间期的导联间差异显著高于未接受治疗的患者（88±22毫秒对59±23毫秒，P<.001）。
187-ch RIDM-ECG测定的校正Tp-e间期的导联间差异可能与接受CRT-D的心力衰竭患者的适当ICD治疗有关。
