实验性心肌梗塞心室晚电位及诱发室速或室颤的食管及心外膜实时记录对比研究

实验性早期急性心肌梗塞30只犬,用电极端弯曲可控导管经食管实时记录心室晚电位(ESO-VLPs),与心外膜梗塞区实时记录心室晚电位(IZ-VLPs)对比研究结果。窦性心律时IZ-VLPs阳性76.6％,ESO-VLPs阳性70％,其敏感性、特异性及预测值各为78.3％,57.1％及85.7％。程序心室刺激诱发持续性室速(VTs)9只,室颤(VF)11只,IZ-VLPs阳性和ESO-VLPs阳性犬诱发VTs/VF的预测值为78.3％比81％(P>0.05),IZ-VLPs和ESO-VLPs阴性未诱发VTs/VF的预测值为71.4％比66.6％(P>0.05)。表明食管实时记录心室晚电位是可行的。

A COMPARATIVE STUDY OF VENTRICULAR LATE POTENTIALS RECORED ON ESOPHAGUS AND EPICARDIUM AND ITS RELATION TO INDUCTIVELY SUSTAINED VENTRICULAR TACHYCARDIA AND FIBRILLATION IN EXPERIMENTAL INFARCTION

Animal experiment was performed in 30 dogs to study myocardial infarction in its early stage. An esophageal catheter with adjustable pole was used to record the esophageal ventricular late potentials (ESO-VLPs,) and it was compared with epicardium (IZ-VLPs). During sinus rhythm the positive rate of IZ-VLPs and ESO-VLPs were 76.6% and 70%; the sensitivity, specificity and the predictive value of ESO-VLPs were 78.3%, 57.1% and 85.7%, respectively. By using a programmed ventricular stimulator to induce sustained ventricular tachycardia (VTs, 9 cases) and ventricular fibrillation (VF, 11 eases), the positive predictive value for induced VTs/VF in IZ-VLPs with ESO-VLPs were 78.3% vs. 81%(P>0.05) and the nagative predictive value for non-induced VTs/VF in IZ-VLPs with ESO-VLPs were 71.4% vs. 66.6% (P>0.05). It has shown that the microvolt signal from a delayed ventricular activation can be detected reliably on the esophageal surface.