Department of Cardiology, Westmead Hospital, Sydney, Australia Faculty of Medicine, University of Sydney, Australia.
J Cardiovasc Electrophysiol. 2011 Mar;22(3):334-9. doi: 10.1111/j.1540-8167.2010.01900.x. Epub 2010 Sep 14.
The study aim was to determine the utility of noncontact mapping in acute ischemic ventricular fibrillation, by direct comparison with simultaneously acquired multisite contact needle recordings.
Noncontact mapping has emerged as a promising tool to make percutaneous high-density intracardiac electrical recordings in clinical and research settings. Previous large-animal mapping studies of ischemic VF have used electrodes in contact with the fibrillating myocardium. A previous report of noncontact mapping in VF used a single intracardiac catheter to validate noncontact recordings.
We studied the spontaneous onset of VF in 8 sheep, after acute occlusion of the left anterior descending coronary artery. Simultaneous unipolar recordings of endocardial electrical activation were made with the most endocardial electrode of 32 transmural plunge needles (contact electrograms; CE), and an Ensite noncontact catheter in the left ventricle (noncontact virtual electrograms; NCVE). The lag-shifted morphology cross-correlation between individual NCVE and CE pairs during VF was calculated.
The mean lag-shifted cross-correlation coefficient during manually selected sinus rhythm beats was 0.89 ± 0.006, and 0.80 ± 0.009 in VF (P < 0.05). The mean absolute time shift was 7.3 ± 0.5 ms in sinus rhythm, and 23.8 ± 0.9 ms in VF (P < 0.001). Fast Fourier transform demonstrated well-correlated dominant frequencies between CE and NCVE. VF myocardial activation maps of NCVE showed organized wavefronts, but dyssynchronous activation in CE.
These data demonstrate errors in activation timing and sequence with noncontact mapping more prominent during VF than sinus rhythm.
本研究旨在通过与同时获取的多部位接触针记录进行直接比较，确定非接触式标测在急性缺血性室颤中的应用价值。
非接触式标测已成为一种有前途的工具，可在临床和研究环境中进行经皮高密度心内电记录。以前使用接触心肌的电极进行缺血性 VF 的大型动物标测研究。以前关于 VF 中非接触式标测的报告使用单个心内导管来验证非接触式记录。
我们研究了 8 只羊急性前降支冠状动脉闭塞后自发性 VF 的发作。同时使用 32 根穿壁 plunge 针的最内心内膜电极（接触电图；CE）和左心室的 Ensite 非接触式导管进行心内膜电活动的单极记录（非接触虚拟电图；NCVE）。在 VF 期间计算了单个 NCVE 和 CE 对之间的滞后移位形态交叉相关。
窦性节律跳动时手动选择的平均滞后移位交叉相关系数为 0.89 ± 0.006，VF 时为 0.80 ± 0.009（P < 0.05）。窦性节律时的平均绝对时间移位为 7.3 ± 0.5ms，VF 时为 23.8 ± 0.9ms（P < 0.001）。快速傅里叶变换显示 CE 和 NCVE 之间存在相关的主导频率。NCVE 的 VF 心肌激活图显示出有序的波阵面，但 CE 显示出不同步的激活。
这些数据表明，与窦性节律相比，NCVE 在 VF 时的激活时间和顺序误差更为明显。
