Localization of the Accessory Pathway in the Wolff‐Parkinson‐White Syndrome from the Ventriculo‐Atrial Conduction Time of Right Ventricular Apical Extrasystoles
Localization of the Accessory Pathway in the Wolff‐Parkinson‐White Syndrome from the Ventriculo‐Atrial Conduction Time of Right Ventricular Apical Extrasystoles
复制标题
从右心室心尖期早搏的心室-心房传导时间定位沃尔夫-帕金森-怀特综合征的辅助通路
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发表时间：
1983
期刊：
影响因子：
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通讯作者：
H. Wellens
中科院分区：
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作者：
Jim Weiss;P. Brugada;D. Roy;F. Bär;H. Wellens
在连续18例Wolff - Parkinson - White综合征患者的电生理研究中，我们研究了马尾草运动性心动过速时导致心房激活的右心室尖部心动过速的室房传导时间与辅助通路位置的关系。辅助通路的位置由最大预兴奋时的δ波形态决定，马戏运动心动过速和心室起搏时的心房激活映射，马戏运动心动过速时束支阻滞对心室-心房传导时间的影响，以及心房不同部位起搏对刺激- δ波间隔的影响。在7例伴有室间隔副通路的患者中，马甲运动性心动过速和右室尖部心动过速后的心室-房传导时间相似（平均差值为0±6 ms，范围为- 5至+ 10 ms）。相比之下，在11例左侧自由壁副通道患者中，右心室顶端收缩后心室-房传导时间增加了46±15 ms（范围为15至65 ms）。因此，测量马甲运动性心动过速时右心室心动过速的心室-心房传导时间提供了一种简单的方法来区分室间隔和左游离壁副通路。这一发现在确定隐蔽性旁路束的位置时可能特别有用。
In 18 consecutive patients with the Wolff‐Parkinson‐White syndrome undergoing electrophysiologic study, the ventriculo‐atrial conduction time of right ventricular apical extrasystoles which advanced atrial activation during circus movement tachycardia was studied in relation to accessory pathway location. Accessory pathway location was determined by delta wave morphology during maximal pre‐excitation, mapping of alrial activation during circus movement tachycardia and ventricular pacing, the effect of bundle branch block on ventriculo‐atrial conduction time during circus movement tachycardia, and the effect of pacing from different sites in the atria on the stimulus‐to‐delta wave interval. In 7 patients with septal accessory pathways, ventriculo‐atrial conduction time was similar during circus movement tachycardia and following right ventricular apical extrasystoles (mean difference 0 ± 6 ms, range ‐5 to + 10 ms). In contrast, in 11 patients with a left free wall accessory pathway, ventriculo‐atrial conduction time increased by 46 ± 15 ms (range 15 to 65 ms) following right ventricular apical exlrasystoles. Therefore, measurement of the ventriculo‐atrial conduction time of right ventricular extrasystoles during circus movement tachycardia provides an easy way to distinguish between septal and left free wall accessory pathways. This finding may be of particular use in determining the location of concealed bypass tracts.