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目的 通过与病理解剖对比,研究非接触式标测系统(EnSite 3000系统)在窦性心律下完成猪心肌梗死后疤痕区标测和导航线性消融的准确性。方法 运用非开胸PTCA球囊堵闭法造成6只猪心肌梗死后10～16周,在其左心室置入一EnSite 3000球囊,构建左心室的三维几何模型,通过动态疤痕标测确定左心室心肌梗死后疤痕区、疤痕边缘与正常非梗死部位交界区和非梗死区域,记录分析这些部位心内电图的差异;运用导航系统指引线性消融,并将系统所确定的疤痕区及导航的消融线与病理分析相对照。结果 系统所确定的疤痕区的面积为(8.4±4.7)cm~2,与病理解剖平均心内膜梗死面积(8.6±3.9)cm~2相比差异无显著性(P>0.05),梗死的部位及边缘均与解剖高度一致。共记录分析系统模拟的408个位点心内双极电图,在梗死区内所记录到的心内电图振幅明显较低(1.3±0.4)mV、持续时间较长(86.4±27.3)ms,且图形更为碎裂,后电位成分较多。在非梗死区心内电图表现为振幅高(5.7±2.1)mV、持续时间短(42.6±7.7)ms、呈单相或双相图形,无碎裂成分出现。交界区的心内电图振幅(3.5±1.8)mV、时间(67.1±16.5)ms和形态均介于两者之间。结论 EnSite 3000系统在窦性心律下可较精确地标测出疤痕组织,能明确解剖学异常与电生理变化的关系,并可准确导航线性消融
OBJECTIVE: To compare the accuracy of pathological anatomy with the non-contact mapping system (EnSite 3000 system) in the scar area detection and navigation ablation of pigs after sinus arrhythmia. Methods A non-thoracotomy PTCA balloon occlusion method was used to induce myocardial infarction in 6 pigs 10 to 16 weeks after myocardial infarction. An EnSite 3000 balloon was placed in the left ventricle to construct a 3D geometric model of left ventricle. Left Left ventricular hypertrophy, left ventricular hypertrophy, left ventricular hypertrophy, left ventricular hypertrophy, left ventricular hypertrophy, left ventricular hypertrophy, left ventricular hypertrophy, left ventricular hypertrophy, left ventricular hypertrophy, left ventricular hypertrophy, Ablation lines and pathological analysis of contrast. Results The area of the scar area determined by the system was (8.4 ± 4.7) cm ~ 2, which was not significantly different from that of the pathological anatomy (8.6 ± 3.9) cm ~ 2 (P> 0.05) Parts and edges are consistent with the anatomy. A total of 408 points simulated intracardiac bipolargraphy were recorded and analyzed. The amplitude of ECG recorded in infarction area was significantly lower (1.3 ± 0.4) mV and longer duration (86.4 ± 27.3) ms, And the graph is more fragmented, more potential components. Electrocardiogram in the non-infarct area showed a high amplitude (5.7 ± 2.1) mV and a short duration (42.6 ± 7.7) ms, showing single or biphasic pattern without fragmentation. The electrocardiogram amplitude (3.5 ± 1.8) mV and time (67.1 ± 16.5) ms in the junctional area were between the two. Conclusion The EnSite 3000 system can accurately detect scar tissue under sinus rhythm and can clearly understand the relationship between anatomical abnormalities and electrophysiological changes and can accurately navigate linear ablation