Hanashima K, Ikeda K, Yamaki M, Tsuiki K, Yasui S
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
Jpn Circ J. 1988 Mar;52(3):203-10. doi: 10.1253/jcj.52.203.
To investigate the utility of body surface isochrone maps for estimating ventricular arrhythmias in patients with previous myocardial infarction, we compared findings of body surface isochrone maps with those of signal-averaged electrocardiograms (SAECGs) and an incidence of ventricular tachycardia (VT). Body surface isochrone mapping was performed in 50 patients with previous myocardial infarction. Eighty-seven unipolar electrocardiograms distributed over the patient's anterior chest and back were recorded simultaneously. For each lead, the activation time was measured as the duration from the onset of QRS to the peak of the R wave. SAECGs were recorded in the same patients to detect late potential (LP) which was considered to last more than 30 msec. Activation delay on isochrone maps (D) was found in 31 of 50 patients. The group D+ had a lower ejection fraction and higher incidence of VT (8/31 (25.8%) vs. 1/19 (5.3%)) and LP (13/31 (41.9%) vs. 2/19 (10.5%)) than the group D-. There were four patients with sustained VT who had both D and LP. For predicting VT, D has a sensitivity of 88.9% and a specificity of 43.8%. It was decided that abnormal delay on body surface isochrone maps indicates slow conduction of the surviving myocardium and is related to the occurrence of ventricular arrhythmias. We concluded that body surface isochrone maps can be useful in predicting life-threatening arrhythmias in patients with previous myocardial infarction.
为了研究体表等时线图在评估既往心肌梗死患者室性心律失常中的应用价值，我们将体表等时线图的结果与信号平均心电图（SAECG）以及室性心动过速（VT）的发生率进行了比较。对50例既往有心肌梗死的患者进行了体表等时线图绘制。同时记录了分布在患者前胸和后背的87份单极心电图。对于每一个导联，激活时间测量为从QRS波起始到R波峰值的持续时间。在同一批患者中记录SAECG以检测持续时间超过30毫秒的晚电位（LP）。50例患者中有31例在等时线图上发现激活延迟（D）。与D-组相比，D+组的射血分数更低，VT（8/31（25.8%）对1/19（5.3%））和LP（13/31（41.9%）对2/19（10.5%））的发生率更高。有4例持续性VT患者同时存在D和LP。对于预测VT，D的敏感性为88.9%，特异性为43.8%。结果表明，体表等时线图上的异常延迟表明存活心肌传导缓慢，且与室性心律失常的发生有关。我们得出结论，体表等时线图可用于预测既往心肌梗死患者的危及生命的心律失常。
