体表标测q波对显性房室旁道定位的临床意义初探

为探讨房室旁道体表标测图ｑ波分布与旁道位置的关系，采用９１导联体表标测系统观察２６例显性预激综合征（单旁道）患者ｑ波分布图，并与射频消融成功靶点确定的旁道位置比较。发现旁道位置不同，ｑ波分布有别：左室游离壁旁道（１４例）ｑ波分布于左腋中线以后背部上方及右锁骨水平（１２例）；左后间隔旁道（３例）ｑ波局限于右胸背部（３例）。右侧游离壁旁道（７例）ｑ波分布于右胸背部及肋弓下缘（７例）；右前间隔旁道（１例）ｑ波位于右胸背上方（１例）；右后间隔旁道（１例）位于右胸背下方及左胸背第５肋以下（１例）。提示体表标测ｑ波分布有助于消融术前旁道定位。

Distribution Patterns of q Wave on Body Surface Mapping in Patients With an Atrioventricular Accessory Pathway of Various Location

Radiofrequency catheter ablation is a safe and effective approach to cure the tachyarrhythmias associated with Wolff Parkinson White(WPW) syndrome. It is very important to determine the site of accessory atrioventricular pathway before ablation. 26 patients with WPW syndrome of single accessory pathway were studied by the 91 lead body surface mapping(BSM). The q wave distribution pattern from the parameter mapping was related to the site of accessory atrioventricular pathway which was determined by intracardiac mapping and successful site of ablation.We found that the pathways of different location are associated with different q wave distribution pattern in terms of position, area and the earliest apparent points. This result suggests that the q wave mapping may be useful in the localization of the accessory artioventricular pathway before ablation.