使用铂电极记录单相动作电位的可行性研究

The feasiblity of recording monophasic action potentials with a platinum-electrode ablation catheter

目的探讨使用用于射频消融的普通铂电极记录心内膜单相动作电位(MAP)的可行性。方法 20例阵发性室上性心动过速行导管消融的患者分两组,分别使用铂电极和银-氯化银(Ag-AgCl)电极在右室心尖部及右室流出道进行MAP标测,测量各标测点MAP的振幅(AMP)、动作电位复极达90%的时程(APD90)、激动时间(AT)和复极时间(RT),比较两组间各指标的差异。结果在右室心尖部和右室流出道Ag-AgCl电极组和铂电极组分别测得48和46个标测点,其中铂电极组仅有3个标测点基线干扰较大,并且该组振幅大于10 mV的标测点共有33个,基本满足稳定的MAP信号的要求。与Ag-AgCl电极组相比,铂电极组测得的MAP的AMP、APD90、AT、RT值均没有显著差异(P均>0.05)。结论在临床研究中使用铂电极代替Ag-AgCl接触电极作为同时记录MAP和射频消融的两用电极具有可行性。

Objective To investigate the feasibility of recording the endocardial monophasic action potentials （MAP） with a platinum-electrode ablation catheter. Methods Muhipoint endocardium monophasic action potem tials（MAP） were recorded in twenty patients pre{ormed catheter ablation of tachycardia. According to their different recording methods, the twenty patients were divided into two groups： the platinum-electrode group and the Ag- AgC1 electrode group. The amplitudes（AMP）, MAP duration at 90% repolarization（APD90 ）, the activation time （AT） and the repolarization time（RT） during sinus rhythm were recorded at every recorded site. Results In the recorded sites of right ventricular apex and right ventricular outflow tract, the Ag-AgCl-electrode group and the platinum electrode group recorded 48 and 46 MAPs separately. Of all the MAPs in the platinum-electrode group, only 3 MAPs had baseline disturbances 10% of the plateau amplitudes of the MAPs, at the same time , the plateau amplitudes of the MAPs were 〉10 mV in 33 of the all 46 MAPs in that group ,which met the needs of stable MAP signals .Compared to the Ag AgCl-electrode group, the AMP, APD90, AT, RT in the platinum electrode group were not distinctly different （P〉0.05）. Conclusions Our study suggested that it is possible to recording monophasic action potentials with a platinum-electrode ablation catheter instead of Ag-AgC1 electrodes.