ABSTRACT
Surgical treatment of ventricular arrhythmias (VAs) is an effective method of solving sudden cardiac death. The important problem of surgical treatment of VAs is the topical diagnosis of the origin of arrhythmia. The precise localization of this area is extremely important for effectiveness of operation. The method of epicardial mapping of the heart during the induced paroxysm of VA is widely used for solving this problem. This problem is difficult when it is impossible to induce tachycardia during the operation. The method of pace-mapping was developed for such cases. This method includes sequential electrical stimulation of ventricles with ECG recording and comparison between intraoperative and preoperative ECG. The goal is the identification of the area of ventricles closed to preoperative ECG with VA. Manual processing of these data is difficult and takes time. The results of such processing have a low precision. That is why we propose using computerized methods. The goal of this investigation is to develop computerized methods of topical ECG diagnosis of VA. We propose a method of computer comparative analysis of ECG morphology for spontaneous and stimulated ECG. The goal is the determination with stimulated ECG the point of ventricles with ECG closest to spontaneous ECG during ventricular tachycardia. Nine patients (15-57 years old) with VA were studied. The main result of this investigation is that computerized pace-mapping method is an effective tool for topical diagnostics of different forms of VAs, which is impossible to induce by electrical programmed stimulation.
Subject(s)
Arrhythmias, Cardiac/diagnosis , Cardiac Pacing, Artificial/methods , Diagnosis, Computer-Assisted , Electrocardiography , Heart Conduction System/physiopathology , Adolescent , Adult , Arrhythmias, Cardiac/physiopathology , Cardiac Complexes, Premature/diagnosis , Cardiac Complexes, Premature/physiopathology , Computer Systems , Humans , Middle Aged , Models, Cardiovascular , Software , Tachycardia, Paroxysmal/diagnosis , Tachycardia, Paroxysmal/physiopathology , Ventricular Function/physiologyABSTRACT
The paper deals with the problems in the diagnosis and treatment of patients with the most malignant rhythm disturbances, i. e. ventricular arrhythmias. A great emphasis is laid on the so-called "primary" arrhythmias appearing without a manifest cardiac abnormality. The arrhythmias proceed unfavorably and are followed by profound morphofunctional myocardial changes occurring chiefly in the upper portions of the ventricular septum, more frequently on the right. Cryodestruction of arrhythmogenic areas is an effective method for surgical correction of arrhythmias having an unfavorable course.
