title: Body-surface distribution of changes in activation-recovery intervals before and after catheter ablation in patients with Wolff-Parkinson-White syndrome: clinical evidence for ventricular 'electrical remodeling' with prolongation of action-potential duration over a preexcited area.
abstract: BACKGROUND
  T-wave abnormalities after catheter ablation in patients with manifest Wolff-Parkinson-White (WPW) syndrome have been attributed to a continuation of repolarization abnormalities induced by preexcitation (cardiac memory).
  
  
  RESULTS
  To clarify changes in repolarization properties, we analyzed the activation-recovery interval (ARI) obtained from body-surface maps and the relationship between the activation time (AT) and ARI in 30 patients with WPW syndrome (group A, 18 patients with manifest left-sided accessory pathway; group B, 7 patients with manifest right-sided accessory pathway; and group C, 5 patients with concealed left-sided accessory pathway) before, 1 day after, and 1 week after ablation. The ARI significantly decreased 1 week after ablation compared with before and 1 day after ablation over the preexcited area in groups A and B. Correlation coefficients between the AT and ARI showed a significantly (P<.01) stronger inverse relationship before (r=-.58) and 1 week after (r=-.64) ablation than 1 day after ablation (r=-.46) in groups A and B. In group C, the ARI and correlation coefficients between the AT and ARI showed no significant changes.
  
  
  CONCLUSIONS
  These findings suggest a prolongation of the action-potential duration over the preexcited area before and just after ablation as ventricular "electrical remodeling," a decrease in the inverse relationship between the AT and action-potential duration 1 day after ablation, and a gradual recovery of the action-potential duration over the preexcited area and inverse relationship 1 week after ablation.
authors.affiliation: First Department of Internal Medicine, University of Nagoya School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Akahoshi
authors.forename: M
authors.initials: M
authors.lastname: Hirai
authors.forename: Y
authors.initials: Y
authors.lastname: Inden
authors.forename: H
authors.initials: H
authors.lastname: Sano
authors.forename: A
authors.initials: A
authors.lastname: Shimizu
authors.forename: T
authors.initials: T
authors.lastname: Kondo
authors.forename: M
authors.initials: M
authors.lastname: Makino
authors.forename: M
authors.initials: M
authors.lastname: Horiba
authors.forename: Y
authors.initials: Y
authors.lastname: Yoshida
authors.forename: N
authors.initials: N
authors.lastname: Tsuboi
authors.forename: H
authors.initials: H
authors.lastname: Hirayama
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.forename: H
authors.initials: H
authors.lastname: Hayashi
authors.forename: H
authors.initials: H
authors.lastname: Saito
mesh_terms: D000200:Action Potentials; D000328:Adult; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011930:Reaction Time; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology* / Q000601:surgery*