Comparative study of five preoperative methods for the localization of accessory pathways in the Wolff-Parkinson-White syndrome.
One hundred and thirty-four cases of Wolff-Parkinson-White syndrome were studied to evaluate the relative usefulness of electrocardiography (ECG), electrophysiological studies (EPS), body surface mapping (BSM), gated blood-pool phase analysis (nuclear studies), and vectorcardiography (VCG) in the localization of the accessory pathway (ACP). In comparison with the final localization verified by intraoperative studies, 93.4% in 8-region ACP localization (97.7% in 4-region ACP localization) could be correctly localized by ECG using our criteria, 83.9% (86.8%) by EPS, 82.6% (95.8%) by BSM, 78.8% (87.7%) by nuclear studies, and 67.3% (78.0%) by VCG. It was concluded that: (a) ACP can be localized preoperatively with considerable accuracy by using our simple ECG criteria. (b) The EPS method has some limitation, especially with respect to 8-region ACP localization. (c) Our observation showed no evidence that BSM, VCG, or nuclear studies were superior to ECG in ACP localization. (d) Among the 5 methods studied, ECG and EPS appear to be the appropriate procedures for preoperative ACP identification.
Yuan
S W
SW
Department of Surgery (I), Kanazawa University, Japan.
Iwa
T
T
Misaki
T
T
Mukai
K
K
Matsunaga
Y
Y
Bando
H
H
Nakajima
K
K
Numa
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D004566:Electrodes; D004594:Electrophysiology; D005260:Female; D015637:Gated Blood-Pool Imaging; D006329:Heart Conduction System / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D014672:Vectorcardiography; D014927:Wolff-Parkinson-White Syndrome / Q000473:pathology*