Key result
In patients with old myocardial infarction, the presence of a multipolar QRST isointegral map was associated with a significantly higher induction rate of monomorphic sustained ventricular tachycardia compared to a unipolar map (85% vs 38%).
Why the study?
Does a multipolar QRST isointegral map predict the inducibility of monomorphic sustained ventricular tachycardia by ventricular pacing in patients with old myocardial infarction?
Observational (n=87)
No
Does a multipolar QRST isointegral map predict the inducibility of monomorphic sustained ventricular tachycardia by ventricular pacing in patients with old myocardial infarction?
Absolute Event Rate: 85% vs 38%
p-value: p=<0.05
Multipolar QRST isointegral maps suggest the presence of unidirectional block and are associated with a higher inducibility of monomorphic sustained ventricular tachycardia in patients with old myocardial infarction.
May identify reentry substrate in old MI; hypothesis-generating for VT risk stratification, needs prospective validation.
陳旧性心筋梗塞 (OMI) と特発性心室頻拍 (VT) においてQRST isointegral mapと心室ペーシングによるVTの易誘発性との関連について検討した.対象は持続性VT (sVT) を伴うOMI 21例, 特発性sVT 26例および健常者40例であり, 体表面電位図を記録しQRST isointegral mapを作成した.OMIと特発性sVTに対してVT誘発試験を施行し, VTの易誘発性について検討した.多双極子性mapの頻度は, OMI 62%, 特発性sVT 8%, 健常者0%であり, OMIはほかの2群に比べ高頻度であった (p<0.01) .OMIでのmonomorphic sVTの誘発は, 多双極子性map 85%, 単一双極子性map 38%と多双極子性mapで高率であり (p<0.05) , また機序はreentryであると診断された.特発性sVTではVT易誘発性に関して多双極子性mapと単一双極子性mapとの間に差はなかった.以上, OMIでは多双極子性QRST isointegral mapとmonomorphic sVTの誘発との間に関連が認められること, およびmonomorphic sVTの機序がreentryであることから, 多双極子性ORST isointegral mapは一方向性ブロックを形成する部位の存在を示唆する可能性があると考えられた.
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Nirei et al. (1994) conducted an observational in Ventricular tachycardia (n=87). Multipolar QRST isointegral map vs. Unipolar QRST isointegral map was evaluated on Induction of monomorphic sustained ventricular tachycardia (sVT) by ventricular pacing (p=<0.05). In patients with old myocardial infarction, the presence of a multipolar QRST isointegral map was associated with a significantly higher induction rate of monomorphic sustained ventricular tachycardia compared to a unipolar map (85% vs 38%).
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