Iturralde Torres Pedro
Departamento de Electrofisiología Clínica, Instituto Nacional de Cardiología, Ignacio Chávez, INCICH, Juan Badiano No. 1 Col. Sección XVI, Tlalpan 14080 México, D.F.
Arch Cardiol Mex. 2004 Jan-Mar;74 Suppl 1:S84-7.
Initial electrophysiologic assessment and radiofrequency ablation can be abbreviated when accurate localization of the accessory pathway is available before the procedure. Several criteria have been previously proposed for localization of accessory pathways from the surface electrocardiogram. Rosenbaum classified ECG of patients with preexcitation but did not include septal connections. Gallagher based their analysis on surgical ablation identified 10 locations around the tricuspid and mitral valve and the septum. The thoracic cycle electrocardiogram identified correctly the preexcitation location and its very useful for the differential diagnosis between right on left pathway, particularly in the posterior septal region. We also chose leads III, V1 and V2 to analyze the frontal and horizontal planes of the heart activation and we could easily identify the sites of right and left preexcitation. With our algorithm, we were able to correctly identify the location of the accessory pathway in 88% of the patients, with a high success rate of the radiofrequency ablation.
如果在手术前能够准确地定位旁路，那么初始电生理评估和射频消融可以简化。先前已经提出了几种从体表心电图定位旁路的标准。罗森鲍姆对预激患者的心电图进行了分类，但未包括间隔连接。加拉格尔基于手术消融进行分析，确定了三尖瓣、二尖瓣和间隔周围的10个位置。胸周期心电图能正确识别预激部位，对鉴别右侧在左侧旁路，特别是在后间隔区域非常有用。我们还选择Ⅲ导联、V1导联和V2导联来分析心脏激动的额面和水平面，并且能够轻松识别左右预激部位。通过我们的算法，我们能够在88%的患者中正确识别旁路位置，射频消融成功率很高。
