体表电位标测判定预激综合征旁路的评价

Assessnent of BSPM in localizing the accessory AV pathway in patients with Wolff-Parkinson-White syndrome

目的 评价体表电位标测在房室旁路定位中的准确性和可行性。方法 5 2例常规行射频导管消融 (RFCA)的显性预激综合征 (Wolff- Parkinson- White syndrom e,WPW)病人 ,术前后体表电位标测 (Body Surface Potential Mapping,BSPM)。旁路定位采用 :(1)等电位图 :除极 40 ms后 ,稳定持续 10 ms以上的极小值位置。 (2 )等积分图 :等积分图中极小值的位置。其结果与同步 12导联心电图 (ECG)和有创的电生理检查相对照。结果 (1) BSPM与电生理检查完全一致符合率为 71.2 % ,而 ECG为 6 5 .4% ,P>0 .0 5 ;(2 )与电生理检查相近符合率为 96 .2 % ,而 ECG为 86 .5 % ,P>0 .0 5。结论 初步观察显示 ,用 BSPM对房室旁路进行定位是可行的 ,SBPM法更便于判断 ,可能比 12导 ECG更准确。

Objective The present study was to evaluate the accuracy and feasibility of body surface potential mapping(BSPM) in localizing accessory AV pathway.Mothods 52 patients with overt WPW syndrome enrolled for routine ablation procedure were included.The sites of bypass tract were determined by(1) Isopotential mapping.The location of minimum at the time point of 40 ms after depolarization start,which lasted for at least 10ms.(2)Isointegral mapping.Spot of minimum in isointegral maps.The results were compared with that of synchronous 12-lead electrocardiography and intraprocedural electrophysiological examination.Results It revealed that:(1)The complete agreement of BSPM with electrophysiological examination was 71.2%,whereas ECG was 65.4%, P >0 05.(2)The incomplete agreement of BSPM with electrophysiological localization was 96.2%,compared only 86.5% with ECG, P >0 05.Conclusion It is feasible for BSPM to localize the accessory AV pathway in our preliminary study.The localizing modality using BSPM was easier to judgement,and may be more accurate than using standard 12-lead ECG.