Al-Sheikhli Jaffar, Tran Patrick, Siang Rafaella, Niespialowska-Steuden Maria, Mayer Joseph, Dhanjal Tarvinder
Heart Rhythm Research Group, Division of Biomedical Sciences, Warwick Medical School, Clinical Sciences Research Laboratory Coventry, UK.
University Hospital of Coventry and Warwickshire NHS Trust Coventry, UK.
Arrhythm Electrophysiol Rev. 2024 Dec 20;13:e22. doi: 10.15420/aer.2024.39. eCollection 2024.
Functional substrate mapping has emerged as an essential tool for electrophysiologists, overcoming many limitations of conventional mapping techniques and demonstrating favourable long-term outcomes in clinical studies. However, a consensus on the definition of 'functional substrate' mapping remains elusive, hindering a structured approach to research in the field. In this review, we highlight the differences between 'functional mapping' techniques (which assess tissue response to the 'electrophysiological stress' using short coupled extrastimuli) and those highlighting regions of slow conduction during sinus rhythm. We also address fundamental questions, including the optimal degree of electrophysiological stress that best underpins the critical isthmus and the role of wavefront activation in determining the most effective ablation site.
功能性基质标测已成为电生理学家的一项重要工具，克服了传统标测技术的许多局限性，并在临床研究中显示出良好的长期效果。然而，对于“功能性基质”标测的定义仍未达成共识，这阻碍了该领域研究的结构化方法。在本综述中，我们强调了“功能性标测”技术（使用短耦合期外刺激评估组织对“电生理应激”的反应）与那些突出窦性心律期间缓慢传导区域的技术之间的差异。我们还讨论了一些基本问题，包括最能支撑关键峡部的最佳电生理应激程度以及波前激活在确定最有效消融部位中的作用。
