Kautzner Josef, Peichl Petr
Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, Prague 14021, Czech Republic.
Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, Prague 14021, Czech Republic.
Card Electrophysiol Clin. 2019 Dec;11(4):675-688. doi: 10.1016/j.ccep.2019.08.006.
In stable ventricular tachycardia (VT), activation mapping and entrainment mapping are the most important strategies to describe the reentrant circuit and its critical components. In many patients, however, VT is noninducible or hemodynamically unstable and unmappable. Several technological advances have broadened ablation options in unmappable VTs. Preprocedural imaging and intraprocedural imaging play an important role in location and extent of the substrate. Electroanatomic mapping with several technological improvements allows more precise electrical assessment of the substrate. A combination of imaging and electroanatomic mapping allows substantial modification of arrhythmogenic substrate in sinus rhythm or during device pacing without hemodynamic compromise.
在稳定性室性心动过速（VT）中，激动标测和拖带标测是描述折返环及其关键组成部分的最重要策略。然而，在许多患者中，室性心动过速无法诱发，或血流动力学不稳定且无法标测。多项技术进步拓宽了无法标测的室性心动过速的消融选择。术前成像和术中成像在确定基质的位置和范围方面发挥着重要作用。经过多项技术改进的电解剖标测能够对基质进行更精确的电评估。成像与电解剖标测相结合，能够在窦性心律或器械起搏期间对致心律失常基质进行实质性改良，而不会造成血流动力学损害。
