Tomita Y, Hirai M, Yanagawa T, Sano H, Kondo T, Inden Y, Ichihara Y, Hayashi H, Tsuboi N, Hirayama H, Ito T, Saito H
First Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Am J Cardiol. 1996 Jan 1;77(1):59-63. doi: 10.1016/s0002-9149(97)89135-7.
We analyzed 87-lead body surface QRST time-integral values (QRST values) in 29 patients with Wolff-Parkinson-White syndrome (group A, 17 patients with manifest left-sided accessory pathway; group B, 6 patients with manifest right-sided accessory pathway; and group C, 6 patients with concealed left-sided accessory pathway), before, 1 day after, and 1 week after radiofrequency catheter ablation (RCA). The number of leads with abnormal QRST values was significantly lower 1 week after RCA compared with those before RCA and 1 day after RCA in groups A and B (p < 0.05); there was no significant difference in QRST values before and 1 day after RCA in groups A and B. The QRST values over areas with preexisting repolarization abnormalities were significantly altered 1 week after RCA compared with before and 1 day after RCA in groups A and B (p < 0.01). However, there was no significant difference in the QRST values over areas without preexisting abnormalities before RCA. In group C, there were no significant differences in the QRST values or the number of leads with abnormal QRST values before, 1 day and 1 week after RCA. In conclusion, RCA did not significantly influence repolarization properties over areas without preexisting abnormalities, but gradually reduced preexisting repolarization abnormalities, which were closely related to the location of the accessory pathway in patients with manifest Wolff-Parkinson-White syndrome. Our results suggest that body surface QRST values are useful for assessment of repolarization abnormalities during the periablation period.
我们分析了29例预激综合征患者（A组：17例左侧显性旁路患者；B组：6例右侧显性旁路患者；C组：6例左侧隐匿性旁路患者）在射频导管消融（RCA）术前、术后1天及术后1周的87导联体表QRST时间积分值（QRST值）。A组和B组中，与RCA术前及术后1天相比，RCA术后1周时QRST值异常的导联数显著减少（p<0.05）；A组和B组RCA术前与术后1天的QRST值无显著差异。A组和B组中，与RCA术前及术后1天相比，RCA术后1周时，原有复极异常区域的QRST值显著改变（p<0.01）。然而，RCA术前无原有异常区域的QRST值无显著差异。C组中，RCA术前、术后1天及术后1周的QRST值或QRST值异常的导联数均无显著差异。总之，RCA对无原有异常区域的复极特性无显著影响，但能逐渐减轻原有复极异常，这与显性预激综合征患者旁路的位置密切相关。我们的结果表明，体表QRST值有助于评估消融围手术期的复极异常。
