Stevenson S A, Jenkins J M, DiCarlo L A
University of Michigan, Ann Arbor, USA.
Pacing Clin Electrophysiol. 1997 Nov;20(11):2730-8. doi: 10.1111/j.1540-8159.1997.tb05430.x.
This study investigated the effectiveness of correlation waveform analysis for identifying different ventricular electrogram morphologies of multiple VTs in the same patient. Patients with implantable antitachycardia devices are commonly subject to the occurrence of more than one distinct monomorphic VT. Each of these VTs may have unique therapeutic alternatives for termination. VTs with identical and different monomorphic configurations were recorded (1-500 Hz) using distal bipolar (1 cm) and distal unipolar electrograms from the right ventricular apex. Thirty-six distinct monomorphic VTs induced in 15 patients were analyzed. Nine VTs with identical morphologies (12/12 surface ECGs) were induced twice and used as a control. A template was created for each VT induced. Correlation waveform analysis was used to compare each depolarization of all other VTs induced subsequently in the same patient. The mean correlation coefficient (p mu) of cycle-by-cycle analysis was used as a discriminant function: p mu > or = 0.95 was considered matched; and p mu < 0.95 was considered distinct. From the control population, VTs were successfully classified as identical in 9 of 9 cases (100%) using both bipolar and unipolar electrograms. VTs with different monomorphic configurations were successfully classified as being different in 31 of 33 cases (94%) using bipolar electrogram analysis and in 29 of 33 cases (88%) using the unipolar. Template matching is effective for detecting: (1) the recurrence of VTs, which are identical; and (2) the occurrence of a VT with a different configuration. This method appears effective using either unipolar or bipolar intracardiac waveforms.
本研究调查了相关波形分析在识别同一患者多种室性心动过速（VT）不同心室电图形态方面的有效性。植入抗心动过速装置的患者通常会出现不止一种不同的单形性VT。每种VT可能有独特的终止治疗方案。使用来自右心室心尖的远端双极（1厘米）和远端单极电图记录（1 - 500赫兹）具有相同和不同单形配置的VT。对15例患者诱发的36种不同单形性VT进行了分析。9种形态相同的VT（12/12体表心电图）被诱发两次并用作对照。为每种诱发的VT创建一个模板。使用相关波形分析比较同一患者随后诱发的所有其他VT的每个去极化。逐周期分析的平均相关系数（p mu）用作判别函数：p mu≥0.95被认为匹配；p mu＜0.95被认为不同。在对照组中，使用双极和单极电图在9例中的9例（100%）成功将VT分类为相同。使用双极电图分析在33例中的31例（94%）以及使用单极电图在33例中的29例（88%）成功将具有不同单形配置的VT分类为不同。模板匹配对于检测：（1）相同VT的复发；以及（2）具有不同配置的VT的出现是有效的。使用单极或双极心内波形，这种方法似乎都是有效的。
