Yuan S, Blomström P, Pehrson S, Olsson S B
Department of Cardiology, University Hospital, Lund, Sweden.
Int J Card Imaging. 1991;7(3-4):193-205. doi: 10.1007/BF01797752.
Noninvasive localization of the accessory pathway (AP) in patients with the Wolff-Parkinson-White syndrome and of the site of origin of ventricular tachycardia (VT) is reviewed. 12-lead electrocardiography (ECG) is the most readily available method for localization of both the AP and the site of VT origin. Many published ECG criteria are introduced. The application of body surface potential mapping, vectorcardiography, nuclear phase imaging, echocardiography, computed tomography, nuclear magnetic resonance, and signal-averaged ECG in the localization of these arrhythmogenic substrates is also described. We believe that ECG is the most sensitive noninvasive method for AP localization as well as being convenient and simple; it may be used as the only noninvasive method for the initial evaluation. The left lateral AP, which occurs with an incidence of more than 40%, could be localized preoperatively by noninvasive methods only. For localization of the site of VT origin, none of the noninvasive methods is accurate enough for guiding the surgical and catheter-mediated ablative therapies so far.
回顾了 Wolff-Parkinson-White 综合征患者旁路（AP）的无创定位以及室性心动过速（VT）起源部位的无创定位。12 导联心电图（ECG）是用于 AP 和 VT 起源部位定位的最容易获得的方法。介绍了许多已发表的 ECG 标准。还描述了体表电位标测、向量心电图、核相位成像、超声心动图、计算机断层扫描、核磁共振和信号平均心电图在这些致心律失常基质定位中的应用。我们认为，ECG 是 AP 定位最敏感的无创方法，既方便又简单；它可作为初始评估的唯一无创方法。发生率超过 40% 的左侧旁路仅通过无创方法即可在术前定位。对于 VT 起源部位的定位，到目前为止，没有一种无创方法足够准确以指导手术和导管介导的消融治疗。
