预激旁道体表等电位图标测的临床研究

Clinical Study of Body Surface Isopotiential Mapping in Localizing the Accessory Pathway in Patients with Wolff-Parkinson-White Syndrome

目的 :研究体表电位标测 (dodysurfacepotentialmapping ,BSPM )定位显性旁道 (accessorypath way ,AP)的准确性 ,进一步探索标测的方法学 .方法 :41例常规行射频消融术 (radiofrequencycatheterabla tion ,RFCA)的预激综合征 (wolff- parkinson -whitesyndrome,WPW )病人 ,分别进行BSPM及同步 12导联体表心电图 (electrocardiography ,ECG)检查 .间歇性WPW和小δ波WPW食道调搏使δ波出现、增大时标测 .采用BSPM程序法和马长生流程图法定位AP .其结果与成功消融靶点相对照 .结果 :BSPM与消融靶点完全符合率 82 9% ,ECG 64 4% ,P <0 0 5 .结论 :( 1)BSPM定位WPW显性AP的准确率高于ECG ;( 2 )干预使间歇性WPW、小δ波WPW定位变成可能。

Objective This study was to discover the accuracy of body surface potential mapping(BSPM) in localizing accessoey pathway(AP),and probe its methodology and tenichque.Methods: 41 patients with WPW syndrome , who were given radiofrequency ablation therapies, underwent BSPM and synchronous 12-lead electrocardiography examination before RFCA. Both BSPMs and ECGS were recorded in patients with the intermittent WPW syndrome and the small delta wave WPW syndrome when these delta waves became larger by means of esophageal pacing. We selected the BSPM's procedure methods and Machangsgeng's methods to identify the sites of AP. The results were compared with the target of successful ablation. Results: The complete agreement of BSPM with the target of successful ablation was 82.9%, whereas ECG was 64.4%, P<0.05. Conclusions: (1)It is more accurate for BSPM to localize the AP than that of synchronous 12-lead electrocardiogeaphy. (2) It is possible to determine the AP in patients with intermittent WPW syndrome and it is more accurate to localizes the AP in patients with small delta wave WPW syndrome.