Medrano G A
Arch Inst Cardiol Mex. 1976 Jul-Aug;46(4):356-80.
The purpose of this study was to clarify certain electrovectorcardiographic aspects suggestive of heart disease associated with W-P-W syndrome. Seventy-six vectorcardiograms with W-P-W features were analyzed. The curves were obtained by Grishman's cube system and in 8 cases by Frank's method, as well. In addition, the conventional electrocardiograms corresponding to 55 vectorcardiograms, were studied. Not all the electrocardiographic and vectorcardiographic tracings were recorded simultaneously. The W-P-W syndrome was classified as type A when the electrical records suggested a pre-excitation phenomenon in the left postero-superior septal mass, probably with a partial "wave jumping" toward the right anterior septal mass. The W-P-W syndrome was judged to be of type B when the electrical tracings showed a pre-excitation in the right anterior septal mass, probably with a partial "wave jumping" toward the left posterior septal mass. The results of this study permit the following conclusions: 1. It seems justified to assert that the calssification of the W-P-W syndrome must be realized deductively on the basis of the sequence of the ventricular activation and of the heart position. 2. An interval of 30 msec. or more between the end of initial slurring and the vertex or middle point of the R loop permits inferring the coexistence of left ventricle hypertrophy. 3. The presence of an inactivable zone due to myocardial infarction should be suspected on the basis of segmentary irregularities or distortions of the electrical curves, while extensive deformations are more suggestive of myocardiopathy. 4. The duration of terminal slurrings does not depend on that of the initial ones. However, when the initial slurrings are very prolonged, the terminal ones are relatively short. 5. In the presence of W-P-W syndrome, the primary ventricular repolarization changes cannot be considered as pathognomonic of any associated cardiopathy because they are often provoked by drugs.
本研究的目的是阐明某些提示与预激综合征相关的心脏病的心电图向量方面的情况。对76份具有预激综合征特征的心电图向量图进行了分析。这些曲线是通过格里什曼立方系统获得的，还有8例是通过弗兰克方法获得的。此外，还研究了与55份心电图向量图相对应的常规心电图。并非所有的心电图和心电图向量图记录都是同时进行的。当电记录提示左后上间隔区存在预激现象，可能伴有部分“波跳跃”至右前间隔区时，预激综合征被分类为A型。当电记录显示右前间隔区存在预激，可能伴有部分“波跳跃”至左后间隔区时，预激综合征被判定为B型。本研究结果可得出以下结论：1. 可以有理由断言，预激综合征的分类必须基于心室激动顺序和心脏位置进行演绎。2. 初始顿挫结束与R环顶点或中点之间的间隔为30毫秒或更长，提示左心室肥厚并存。3. 基于电曲线的节段性不规则或扭曲，应怀疑存在因心肌梗死导致的失活区，而广泛的变形更提示心肌病。4. 终末顿挫的持续时间并不取决于初始顿挫的持续时间。然而，当初始顿挫非常延长时，终末顿挫相对较短。5. 在预激综合征存在的情况下，原发性心室复极改变不能被视为任何相关心脏病的特征性表现，因为它们常由药物诱发。
