ベクトル合成187チャネル高分解能心電計 (DREAM-ECG) の開発と臨床応用

抄録

A cardiac sudden death is caused by ventricular fibrillation (VF) of 70% of the time and bradyarrhythmia (cardiac arrest) of 30% of the time. Due to recent advances in electrophysiological and clinical research, the relation of the characteristics of cardiac ion channel and electrophysiological response in patients with lethal arrhythmia became clear. A lethal arrhythmic event such as VF is caused by an acute myocardial infarction, non-uniform delayed conduction due to myocardial scar, drug-induced QT prolongation and microvolt T-wave alternance, and idiopathic VF in Brugada symptom. In this report, we will introduce the development of 187-ch vector-projected high-resolution electrocardiography (DREAM-ECG) and the clinical application. DREAM-ECG can analyze 12-leads ECG, ventricular late potential (LP) by signal-averaged X,Y,Z-leads ECG, and synthesized 187-ch body surface ECGs using the Mason-Likar lead system. In addition, a functional map generated by an integration of LP might evaluate a space distribution of ventricular fractionated activity and high risk patients for implanted cardiac defibrillation. Furthermore, a functional map of RTc (corrected recovery time) dispersion as a repolarization might evaluate a risk stratification of drug-induced QT prolongation and myocardial injury by anti-cancer drugs.