Botvinick E H, Frais M A, Shosa D W, O'Connell J W, Pacheco-Alvarez J A, Scheinman M, Hattner R S, Morady F, Faulkner D B
Am J Cardiol. 1982 Aug;50(2):289-98. doi: 10.1016/0002-9149(82)90179-5.
The ability of scintigraphic phase image analysis to characterize patterns of abnormal ventricular activation was investigated. The pattern of phase distribution and sequential phase changes over both right and left ventricular regions of interest were evaluated in 16 patients with normal electrical activation and wall motion and compared with those in 8 patients with an artificial pacemaker and 4 patients with sinus rhythm with the Wolff-Parkinson-White syndrome and delta waves. Normally, the site of earliest phase angle was seen at the base of the interventricular septum, with sequential change affecting the body of the septum and the cardiac apex and then spreading laterally to involve the body of both ventricles. The site of earliest phase angle was located at the apex of the right ventricle in seven patients with a right ventricular endocardial pacemaker and on the lateral left ventricular wall in one patient with a left ventricular epicardial pacemaker. In each case the site corresponded exactly to the position of the pacing electrode as seen on posteroanterior and left lateral chest X-ray films, and sequential phase changes spread from the initial focus to affect both ventricles. In each of the patients with the Wolff-Parkinson-White syndrome, the site of earliest ventricular phase angle was located, and it corresponded exactly to the site of the bypass tract as determined by endocardial mapping. In this way, four bypass pathways, two posterior left paraseptal, one left lateral and one right lateral, were correctly localized scintigraphically. On the basis of the sequence of mechanical contraction, phase image analysis provides an accurate noninvasive method of detecting abnormal foci of ventricular activation.
研究了闪烁相位图像分析表征异常心室激动模式的能力。在16名电激动和室壁运动正常的患者中，评估了右心室和左心室感兴趣区域的相位分布模式和连续相位变化，并与8名植入人工起搏器的患者以及4名患有预激综合征和δ波的窦性心律患者进行了比较。正常情况下，最早相位角的部位出现在室间隔底部，连续变化影响室间隔体部和心尖，然后横向扩展累及两个心室的主体。7名右心室心内膜起搏器患者最早相位角的部位位于右心室心尖，1名左心室心外膜起搏器患者最早相位角的部位位于左心室侧壁。在每种情况下，该部位与后前位和左侧位胸部X线片上所见的起搏电极位置完全对应，连续相位变化从初始焦点扩展至累及两个心室。在每例预激综合征患者中，均确定了最早心室相位角的部位，且与心内膜标测确定的旁路部位完全对应。通过这种方式，4条旁路途径，即2条左后间隔旁、1条左侧和1条右侧旁路，通过闪烁成像被正确定位。基于机械收缩序列，相位图像分析提供了一种准确的无创检测心室激动异常灶的方法。
