Author/Editor		Vrtovec, Bojan; Gabrijelčič, Tone; Breskvar, Urška; Zupan, Igor
Title		Uporaba prekatnih evociranih potencialov pri bolnikih po transplantaciji srca
Translated title		Intramyocardial electrograms measurements in patients after heart transplantation
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 74, št. Suppl 1
Publication year		2005
Volume		str. I-33-5
Language		slo
Abstract		Background. Adequate detection and treatment of acute allograft rejection is one of the most important predictors of post-transplant survival of cardiac transplant recipients. Recently, a number of novel, non-invasive tools have allowed for earlier detection and better treatment of rejection episodes. Methods. Using the signal from a special pacemaker implanted during the transplant procedure, the intraventricular electrograms can be obtained. The amplitude and the conduction time of the intraventricular electrogram provide information on electrophysiological properties of ventricular myocardium. Due to edema and inflammation during acute rejection, the amplitude of the signal decreases and the conduction time is prolonged. Results. In Ljub jana Medical Center Transplarctation Programme the measurement of intramyocardial electrograms has been shown to represent a reproducible and reliable methodology which led to fewer cardiac biopsy procedures and earlier and better treatment of cardiac allograft rejection. Conclusions. The analysis of intramyocardial electrograms is an important non-invasive tool which allows for better follow-up of cardiac transplant recipients and earlier detection and treatment of allograft rejection episodes.
Summary		Izhodišča. Akutne zavrnitvene reakcije so pomemben dejavnik obolevnosti in smrtnosti po presaditvi srca. Za zgodnje odkrivanje zavrnitev se v novejšem čase uveljavlja več neinvazivnih metod, med katere spada tudi meritev prekatnih evociranih potencialov. Metode. S srčnim spodbujevalnikom, ki ga implantiramo med presaditivijo, lahko v obdobju po presaditvi izmerimo amplitudo in čas prevajanja prekatnih evociranih potencialov. Med akutno zavrnitvijo se elektrofiziološke lastnosti miokarda spremenijo, kar vodi do manjše amplitude evociranih potencialov, podaljša pa se tudi čas prevajanja. Rezultati. Z meritvami prekatnih evociranih potencialov v transplantacijskem programu Kliničnega centra v Ljubljani smo bistveno zmanjšali število biopsij miokarda in omogočili zgodnejše zdravljenje akutnih zavrnitvenih reakcij pri bolnikih po transplantaciji srca. Zaključki. Analiza prekatnih evociranih potencialov je pomembna neinvazivna metoda, ki nam omogoča boljše spremjanje bolnika in pravočasno zdravljenje zavrnitvenih reakcij po transplantaciji srca.
Descriptors		HEART TRANSPLANTATION GRAFT REJECTION CARDIAC PACING, ARTIFICIAL HEART VENTRICLE ELECTROCARDIOGRAPHY