心电成像技术临床应用展望

Electrocardiographic imaging:insights for clinical practice

常规12导联心电图是临床评估及诊断各类心血管疾病的基本手段,但因其心电标测精确性不高,在心律失常潜在电生理机制研究及起源基质标测方面严重受限。新兴的非侵入性心电成像技术(ECGI)可通过逆向重建出心脏各位置的电生理活动的时空动态信息,探究各类心律失常的发生、发展机制,并精确定位其起源部位,有效弥补传统标测技术不足,在指导临床诊治中发挥出十分重要的作用。近年来国内外研究表明,ECGI在各类心律失常及心脏再同步化治疗等多种心血管疾病的诊治中都发挥重要作用。作为无创性手段,三维ECGI是常规心电标测方案的重大进步,其指导临床诊治的巨大潜力也有待挖掘。本文对ECGI的临床应用进展作一述评。

Conventional 12-lead electrocardiogram(ECG)is fundamental for the diagnosis and assessment of cardiovascular diseases.However,due to its relatively inaccuracy,the value of ECG is greatly limited in revealing the underlying electrophysiological mechanism of arrhythmia or locating the origin.The newly established technology,electrocardiographic imaging(ECGI)can noninvasively reconstruct the dynamical electrophysiological activities on the virtual cardiac model,and contribute to studying the mechanisms of arrhythmia,which can overcome the shortcomings of traditional mapping methods and play a valuable role in guiding clinical strategy.Evidence from published studies suggest that,EGCI can be used to provide critical insights regarding the diagnosis and treatment of cardiovascular diseases,such as arrhythmia and cardiac resynchronization therapy.As a non-invasive method,ECGI represents a significant advancement over the conventional standard mapping procedures,and its huge potential in assisting clinical therapeutic decision-making needs to be further explored.