Body Surface Distribution of Abnormally Low QRST Areas in Patients With Wolff‐Parkinson‐White Syndrome Evidence for Continuation of Repolarization Abnormalities Before and After Catheter Ablation
Body Surface Distribution of Abnormally Low QRST Areas in Patients With Wolff‐Parkinson‐White Syndrome Evidence for Continuation of Repolarization Abnormalities Before and After Catheter Ablation
复制标题
沃尔夫-帕金森-怀特综合征患者异常低 QRST 区的体表分布 导管消融前后复极异常持续存在的证据
DOI：
10.1161/01.cir.88.6.2674
复制
发表时间：
1993
期刊：
影响因子：
37.8
通讯作者：
H. Saito
中科院分区：
文献类型：
--
作者：
M. Hirai;N. Tsuboi;H. Hayashi;Mamoru Ito;Y. Inden;H. Hirayama;Teruo Ito;T. Yanagawa;Hiroaki Sano;T. Kondo;Y. Tomita;H. Todoroki;M. Tsuda;H. Saito
背景：沃尔夫-帕金森-怀特综合征（WPW）是否与复极异常有关尚存争议。QRST等积分映射（I-map）在理论上与激活序列无关，与复极化特性有关。射频（RF）导管消融辅助通路（AP）对复极特性影响的I-mapping分析尚未见报道。andResults方法。根据38例WPW患者记录的数据构建i -map，以研究在不受药物影响的生理状态下的复极化特性及其体表分布，并在13例消融患者中阐明射频消融对复极化特性的影响。患者分为三组：A组，AWPW型（左侧AP）患者15例；B组B型（右侧AP） 10例；C组13例成功消融。C组分为3个亚组：CA亚组，A型WPW患者7例；CB亚组，B型WPW 3例；Cc亚组隐匿性WPW 3例。对照组由608名正常人组成。虽然wpwr的I-map与平均正态I-map高度相关（r= 0.87），但A组和B组中最小值的位置与正态I-map有显著差异。22例A型WP1W患者（包括消融患者）中有82%位于背部，13例B型WPW患者（包括消融患者）中有62%位于右前胸部中下部（B±CJ组）。A±CA组和B±CB组分别出现异常低的QRST区（“-2SD区”）。有明显WPW的10例消融患者中，有7例出现极小区和-2SD区异常（CA±CB组）。7例患者经射频消融后，最小值分布在数天或数周内变为正常，“-2SD区”在1周内消失。射频消融后I-map与平均正态I-map的相关系数增加。结论(1)WPW常与复极特性异常有关。(2) A型WPW复极异常位于背部上方，B型WPW复极异常位于右侧中下胸部上方。(3)射频消融后异常立即存在并逐渐恢复正常。这些发现支持了射频消融后12导联心电图ST-T异常可归因于“心脏记忆”的概念。
BackgroundWhether the Wolff-Parkinson-White syndrome (WPW) is associated with repolarization abnormalities is controversial. The QRST isointegral map (I-map) is theoretically independent of the activation sequence and dependent on repolarization properties. There have been no reports concerning the effects of radiofrquency (RF) catheter ablation of accessory pathway (AP) on repolarization properties analyzed by I-mapping. Methods andResults. I-maps were constructed from data recorded in 38 patients with WPW to investigate repolarization properties and their body surface distribution in a physiological state, without pharmacological influences, and in 13 ablated patients to elucidate the effects of RF ablation on repolarization properties. Patients were divided into three groups: group A, 15 patients with type AWPW (left-sided AP); group B, 10 patients with type B (right-sided AP); and group C, 13 patients who were successfuly ablated. Group C consisted of three subgroups: subgroup CA, 7 patients with type A WPW; subgroup CB, 3 patients with type B WPW; and subgroup Cc, 3 patients with concealed WPW. Controls consisted of 608 normals. Although I-maps ofWPWwere highly (r=.87) correlated with the mean normal I-map, the location of the minimum in groups A and B differed significantly from that in normals. The minimum was located over the upper right anterior chest in normal subjects, over the back in 82% of 22 patients with type A WP1W including ablated patients (groups A±CA), and over the mid to lower right anterior chest in 62% of 13 patients with type B WPW including ablated patients (groups B±CJ). Groups A±CA and B±CB had an abnormally low QRST area (“-2SD area”) over the back and right anterior chest, respectively. The abnormally located minimum and the “-2SD area” were present in 7 of 10 ablated patients with manifest WPW (groups CA±CB). After RF ablation, the distribution of the minimum, initially abnormal, became normal over a period of days or weeks, and the “-2SD area” disappeared over 1 week in all 7 patients. Correlation coefficients between I-maps and the mean normal I-map increased after RF ablation. Conclusions(1) WPW is often associated with abnormalities in repolarization properties. (2) Repolarization abnormalities were located over the back in type A WPW and over the right mid to lower chest in type B WPW. (3) The abnormalities remain immediately after RF ablation and gradually normalize. These findings support the concept that ST-T abnormalities in 12-lead ECGs following RF ablation are attributable to “cardiac memory.”
影响因子：
158.5
作者：
JACKMAN, WM;WANG, XZ;LAZZARA, R
通讯作者：
LAZZARA, R
冠状动脉闭塞对模拟左束支传导阻滞异常激活的狗心脏和体表 PQRST 等面积图的影响。
影响因子：
37.8
作者：
Hirai,M;Burgess,MJ;Haws,CW
通讯作者：
Haws,CW