Interrelation of Electrophysiological and Perfusion Changes in Patients With Left Ventricular Aneurysm

The study was aimed at identification of relations between perfusion and electrophysiological changes in left ventricular (LV) myocardium in patients with ischemic heart disease (IHD) with postinfarction LV aneurysm and ventricular tachycardia. The study enrolled 23 patients with the aforementioned disease. Preoperatively, apart from standard clinical examination of cardiosurgical patients, intracardiac electrophysiological study and perfusion single-photon emission computed tomography of myocardium with 99mTc-Technetril were performed. The patients were subjected to coronary artery bypass grafting and left ventricular reconstruction. Assessment of the outcomes showed that electrophysiological condition of left ventricle was dependent on myocardial perfusion. Electrophysologically normal myocardium with electric potential >1.5 mV, transient zone (0.5-1.5 mV) and zones with the potential <0.5 mV differed significantly by the percentage of perfusion: 61, 45, and 35%, respectively. Zones of delayed conduction and those of double potential were located mostly in transient zone of electrical potential conduction with the current amplitude of 0.5-1.5 mV and myocardial perfusion from 35 to 61%. Double potential zone was formed in the area of myocardium with better perfusion (perfusion defect of 55% with preserved metabolism) as opposed to the zone of delayed conduction, where perfusion defect was 40% with low level of metabolic activity. The obtained data has proven the presence of correlation between electrophysiology and perfusion of myocardium. This provides an opportunity to identify electrically unstable myocardial zones with the help of specific computer tomography of myocardium.