Cardiac Arrhythmias Department, National Institute of Cardiology, Warsaw, Poland; Department of Cardiology, Medicover Hospital Warsaw, Warsaw, Poland.
Holobits Software, Warsaw, Poland.
JACC Clin Electrophysiol. 2022 Nov;8(11):1381-1390. doi: 10.1016/j.jacep.2022.07.013. Epub 2022 Sep 28.
The entrainment response, defined as the difference between the postpacing interval and the tachycardia cycle length (TCL) recorded from a mapping catheter, allows to track down the components of the tachycardia loop.
The aim of this study was to evaluate if the postpacing interval measured simultaneously from multiple sites that are remote from the pacing site (PPIR) could be clinically useful in mapping re-entrant circuits.
Ninety-two episodes of entrainment response in 29 patients with different macro-re-entrant tachycardias were evaluated using a standardized entrainment protocol. The spatial distribution of different values of PPIR-TCL in a simulation and a computational model of an entrained re-entrant tachycardia was also analyzed.
The PPIR exceeded TCL by more than 20 milliseconds only if both pacing and recording sites were outside the tachycardia circuit. The PPIR-TCL at in-circuit sites was always ≤20 milliseconds. Sites with negative PPIR-TCL values were found either outside or inside the tachycardia circuit.
Assessment of entrainment response from catheters remote from the pacing site may enhance spatial mapping of the tachycardia circuit. The PPIR-TCL above 20 milliseconds has an excellent positive predictive value in identifying sites outside the tachycardia circuit.
诱发反应定义为从标测导管记录的起搏后间期与心动过速周期长度（TCL）之间的差异，可以追踪心动过速环的组成部分。
本研究旨在评估从起搏部位远处的多个部位同时测量的起搏后间期（PPIR）在标测折返性环路上是否具有临床应用价值。
使用标准化诱发电位方案评估了 29 例不同宏观折返性心动过速患者的 92 个诱发电位反应。还分析了模拟和诱发电位折返性心动过速计算模型中不同 PPIR-TCL 值的空间分布。
只有起搏和记录部位均在心动过速环之外时，PPIR 才会超过 TCL 20 毫秒以上。在环内部位，PPIR-TCL 始终≤20 毫秒。具有负 PPIR-TCL 值的部位位于心动过速环内外。
从起搏部位远处的导管评估诱发电位反应可能会增强心动过速环的空间标测。PPIR-TCL 超过 20 毫秒时，在识别心动过速环外部位方面具有出色的阳性预测值。
