Denes P, Wyndham C R, Amat-y-Leon F, Wu D, Dhingra R C, Miller R H, Rosen K M
Br Heart J. 1977 May;39(5):506-14. doi: 10.1136/hrt.39.5.506.
Atrial pacing at multiple sites was used in an attempt to predict the site of pre-excitation in 5 patients with Wolff-Parkinson-White syndrome with 5 different anomalous pathway locations (right anterior, right posterior, septal, left posterior, and left lateral). At least 3 atrial pacing sites were tested in each patient. Pacing sites tested included high right atrium, low lateral right atrium, low septal right atrium, proximal coronary sinus, and distal coronary sinus. Atrial stimulation sites with shortest and longest stimulus-delta intervals could be identified in each patient, the shortest stimulus-delta interval in each case ranging from 60 to 80 ms. The difference between the shortest and longest stimulus-delta interval in each case ranged from 60 to 110 ms. It was suggested that the site with the shortest stimulus-delta interval corresponded to a site close to the atrial insertion of the anomalous pathway. This hypothesis was confirmed in all cases (3 with epicardial mapping and 2 with retrograde atrial activation data). In conclusion, atrial pacing at multiple sites is helpful in predicting the site of anterogradely conducting anomalous pathways, and appears particularly useful for differentiation of right posterior, left posterior, and septal pre-excitation.
对5例患有预激综合征且旁路位置不同（右前、右后、间隔、左后和左外侧）的患者进行了多部位心房起搏，以尝试预测预激部位。每位患者至少测试了3个心房起搏部位。测试的起搏部位包括高位右心房、低位外侧右心房、低位间隔右心房、冠状窦近端和冠状窦远端。每位患者均可识别出刺激-δ间期最短和最长的心房刺激部位，每种情况下最短刺激-δ间期为60至80毫秒。每种情况下最短和最长刺激-δ间期的差值为60至110毫秒。提示刺激-δ间期最短的部位对应于靠近旁路心房插入处的部位。这一假设在所有病例中均得到证实（3例通过心外膜标测，2例通过逆行心房激动数据）。总之，多部位心房起搏有助于预测顺行传导旁路的部位，尤其有助于区分右后、左后和间隔预激。
