Zoneraich O, Zoneraich S
Chest. 1979 Jul;76(1):70-5. doi: 10.1378/chest.76.1.70.
The atrial depolarization pattern was studied in 22 patients with Wolff-Parkinson-White and Lown-Ganong-Levine syndrome. The influence of the accessory pathways on the shape, magnitude and conduction pattern of the PSE loop was analyzed. An accurate evaluation of the beginning of the delta wave and of the P loop distortions was obtained by using high magnification (1 mV = 30 cm) recordings. The Frank lead system was used. The influence of atrial size (documented by echocardiography) on the PSE loop is emphasized. Special attention has been focused on the terminal vectors as compared to a control group. In Wolff-Parkinson-White syndrome the size of the PSE loop was smaller than in Lown-Ganong-Levine syndrome or in the normal group. When atrial conduction disturbances and/or atrial enlargement was present the PSE loop was larger and distorted. The terminal vectors were abnormally oriented in 75 percent of the patients with Wolff-Parkinson-White syndrome, but only in one with Lown-Ganong-Levine syndrome. The beginning of the delta wave in patients with Wolff-Parkinson-White syndrome was located to the left of the E point in all but two. When the "concertina" effect was present, the direction of the terminal vectors remained unchanged. In four patients with the Lown-Ganong-Levine syndrome, the PSE loop closed, and in three patients, a small opening was present. We suggest that the changes in contour, duration and amplitude of the PSE loop are due to an abnormal pattern of atrial depolorization in Wolff-Parkinson-White syndrome.
对22例预激综合征和短P-R综合征患者的心房去极化模式进行了研究。分析了附加径路对PSE环的形态、大小和传导模式的影响。通过使用高放大倍数（1mV = 30cm）记录，准确评估了δ波的起始和P环的变形情况。采用Frank导联系统。强调了心房大小（经超声心动图记录）对PSE环的影响。与对照组相比，特别关注了终末向量。在预激综合征中，PSE环的大小比短P-R综合征或正常组小。当存在心房传导障碍和/或心房扩大时，PSE环更大且变形。75%的预激综合征患者终末向量方向异常，但短P-R综合征患者中只有1例异常。除2例患者外，预激综合征患者的δ波起始均位于E点左侧。当出现“手风琴”效应时，终末向量方向保持不变。在4例短P-R综合征患者中，PSE环闭合，3例患者存在小开口。我们认为，PSE环的轮廓、持续时间和幅度的变化是由于预激综合征中心房去极化模式异常所致。
