2024-03-28T13:33:14Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:00016668
2022-12-15T03:48:10Z
453:456
471:537:538:1107
心室頻拍の電気生理学的基盤と治療の進展
心室頻拍の電気生理学的基盤と治療の進展
Electrophysiology of Sustained Ventricular Tachycardia
相澤, 義房
sustained ventricular tachycardia
electrophysiologic study
reentry
excitable gap
electrropharmacology
central common pathway
持続性心室頻拍
リエントリー
興奮間隙
電気生理・薬理学的検査
緩徐伝導路
Monomorpic sustained ventricular tachycardia (MSVT) was revisited in relation to the electrophysiologic findings and its application in understanding the mechanism of MSVT and the drug-efficacy. As the underlying heart disease, old myocardial infarction is less common cause of MSVT in Japan (< 1/3), and the majority of MSVT is unrelated to coronary artery disease. However, the mechanism shared a common mechanism:reentry with an excitable gap, as others. The reentrant mechanism has been supported from several electrophysiological findings. Of these, the ability to entrain VT with rapid pacing would be most strong evidence for reentrant mechanism and this could be shown in non-ischemic MSVT. However, the conductive property of the reentrant circuit has been shown to be non-uniform; varying from a case to another and their clinical implications were suggested from our studies. In MSVT associated with underlying heart disease, diseased myocardium showed low amplitude and fragmented electrograms and the area was considered to participate as the central common pathway of reentrant circuit and a preferential action of antiarrhythmic drug on it was shown in all VT studied. As to the drug efficacy, there was no baseline characteristics in predicting the efficacy. However, the significant narrowing of the width of the excitable gap was associated with the drug efficacy and VT became non-inducible after addition of the same drug. The response pattern of the excitable gap to specific drug including class III, was not predictable and further electropharmacological studies will be warranted.
新潟医学会
1998-06
jpn
departmental bulletin paper
http://hdl.handle.net/10191/45911
https://niigata-u.repo.nii.ac.jp/records/16668
AN00182415
00290440
新潟医学会雑誌
新潟医学会雑誌
112
6
295
304
https://niigata-u.repo.nii.ac.jp/record/16668/files/112(6)_295-304.pdf
application/pdf
1.8 MB
2019-08-07