ECG MEASUREMENTS OF VENTRICULAR ARRHYTHMIA MECHANISMS

室性心律失常机制的心电图测量

• 批准号: 2638073
• 负责人: EDWARD J BERBARI
• 金额: $ 20.16万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-01-15 至 1999-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2638073
• 关键词: arrhythmia; clinical research; electrocardiography; heart ventricle; human subject; method development; myocardial infarction

DESCRIPTION: (Adapted from investigator's abstract) Sudden cardiac death occurs in as many as 400,000 people every year in the U.S. and is primarily due to the sequela of ventricular tachycardia followed by ventricular fibrillation or primary ventricular fibrillation. These life threatening ventricular tachyarrhythmias have been treated with anti-arrhythmic drugs and/or implantable defibrillators with variable success. It is our primary hypothesis that the key to an effective interventional strategy for reducing sudden cardiac death directly depends on an accurate noninvasive approach to risk stratification. This diagnostic step will largely determine the clinical efficacy of the available therapies and optimize resource allocation in a cost conscious medical delivery environment. There are several ECG based parameters which identify high risk patients with varying degrees of success. The measurement of cardiac late potentials, heart rate variability, T wave alternans, QT dispersion, ventricular ectopy, and ST segment shifts are examples of these noninvasive tests. Each of these measurements is aimed at quantifying some aspect of the arrhythmia mechanism. The goal of this grant is to develop new analytic methods for quantifying several noninvasive parameters in the context of arrhythmia mechanisms with the outcome being a highly accurate approach to risk stratification. A noninvasive method for identifying the mechanism of specific spontaneous ventricular arrhythmias would directly affect clinical management decisions resulting in the improved medical care and the optimal use of resources. We plan to develop a unified approach for long term ECG recording and analysis using a single recording technology which would provide the basis of all the measurements. This will consolidate a number of tests with a simplified and improved device providing an economical approach to risk stratification. The specific aims of this grant are: 1) Determine the parameters of conventional and intra-QRS cardiac late potentials which are correlated with spontaneous ventricular arrhythmias. 2) Develop new measures of the repolarization phase (QT dispersion, T wave alternans, and the T/U wave region) of the ECG in the context of spontaneous ventricular arrhythmias. 3) Measure the sub-clinical changes (<0.1 mVolt) in the ST segment and correlate this with the occurrence of spontaneous ventricular arrhythmias. 4) Correlate the new ECG indices, retrospectively, in two patient groups: a) those with complex ventricular arrhythmias and/or an existing ICD and b) those with a new or recent myocardial infarction.

描述：（根据调查员的摘要改编）心脏突然死亡 在美国，每年发生多达40万人 由于心室心动过速的后遗症，然后进行心室 纤颤或主要的心室纤颤。 这些威胁生命 心室心律失常已用抗心律失常药物治疗 和/或具有可变成功的可植入除颤器。 这是我们的主要 假设是减少有效介入策略的关键 猝死直接取决于准确的无创方法 风险分层。 这个诊断步骤将在很大程度上确定 可用疗法的临床功效并优化资源 在意识到成本的医疗交付环境中分配。 有 几个基于ECG的参数，这些参数识别高风险患者 成功程度。 心脏后期潜力的测量，心率 可变性，T波替代品，QT色散，心室ectopy和ST 片段变化是这些无创测试的示例。 每个 测量旨在量化心律不齐的某些方面 机制。 这笔赠款的目的是为开发新的分析方法 在心律不齐的情况下量化几个无创参数 结果的机制是一种高度准确的风险方法 分层。 一种无创的方法，用于识别 特定的自发性心律不齐会直接影响临床 管理决策，改善医疗服务和最佳 资源的使用。 我们计划为长期ECG开发统一的方法 使用单个记录技术进行录制和分析 提供所有测量的基础。 这将巩固一个数字 具有简化和改进的设备的测试，提供经济 风险分层的方法。 这笔赠款的具体目的是：1） 确定常规和QRS内心脏的参数晚期 与自发性心律不齐相关的电势。 2）制定复极阶段的新度量（QT分散，T波 在自发的背景下，ECG的替代品和T/U波区域） 心室心律不齐。 3）测量次临床变化（<0.1 mvolt） 在ST段中，并将其与自发发生 心室心律不齐。 4）回顾性新的ECG指数 在两个患者组中：a）患有复杂性心律不齐和/或 现有的ICD和B）具有新的或最近的心肌梗塞的人。