多普勒组织成像技术对显性预激旁道的定位研究

Doppler Tissue Imaging in the Localization of Accessory Pathways is the Patients with Overt Wolff- Parkinson - White Syndrome

目的:本研究旨在评价DTI技术标测显性预激旁道的可行性及准确性。方法:尝试联合应用二维DTI速度图、加速度图观察并标识临床上26例需行射频消融治疗的显性预激综合征患者的旁道位置,并将我们的定位结果与心内电生理检查结果相对照。我们根据同步显示的心电图,将对应于(?)波后局部心室肌最先出现彩色细微收缩点或(和)亮红色加速度变化斑的部位作为DTI定位标准。患者行消融术后再重复以上检查,主要观察局部心室肌的预先激动点是否消失。结果:经DTI标测出的旁道26支,而术中共检出27支旁道(1例患者为双支旁道)。与手术结果比较,DTI标测总符合率高达81.5%。其中6例右前(侧)旁道及3例左后间隔旁道全部标测准确;双支旁道者的位于左前侧壁的激动点未能检出。术后DTI显示25例成功消融的患者中,96%(24/25)对应心电图(?)波后室间隔基中部出现亮红色加速度变化斑。在手术失败的1例患者的左前侧壁仍能探及到细微提前收缩点。结论:具高帧频的DTI新技术可直观实时、准确无创地显示经旁道提前下传的局部心室提前激动点,并能成功指导消融及评估消融效果,不失为临床心脏电生理检查手段的有益补充。

To evaluate the feasibility and accuracy of the site of overt pathways in the patient with overt WPW syndrome by Doppler tissue imaging. Methods: Twenty - six patients undergoing radiofrequency catheter ablation were examined in this study Combined with two - dimensional DTV mode and DTA mode, we visualized and recorded the color systolic point or (and) the bright red accelerate change spot of local ventricular wall at the time just after delta wave in EGG as the standard of our localization. Results: compared with the results of radiofrequency ablation, the total accuracy rate of the pathways by DTI is up to 81 . 57% . Six right anterior pathways and three left posterior ventricular septal pathways were accurately recognized by DTI. The early contraction site located at left ventricular lateral wall wasn't detected in the patient with double accessory pathway. The early ventricular contraction site disappeared in 96% of the patients after successfully radiofrequency ablation. Conclusion: DTI appears to be a promising new noninvasivel method to localize accessory pathway. It is an important complement of cardiac electrophysiology.