title: Effects of Preexcitation Syndrome on Terminal QRS Vector Observed in Spatial Vector.
abstract: BACKGROUND
  Preexcitation syndrome could affect terminal QRS vector, which is not emphasized in clinic. In this study, we made a comparison between vectorcardiogram (VCG) before and after ablation to observe the change of terminal QRS vector. Furthermore, the relationship between the change of terminal QRS vector and accessory pathway (AP) as well as the change of initial QRS vector (delta vector) was analyzed.
  
  
  METHODS
  Thirty patients who were proved to have a single AP by ablation were included. All patients were divided into seven groups based on the AP location. Comparison between VCG before and after ablation was made to observe the change of terminal and delta vector. The relationship between the change of terminal QRS vector and AP location as well as delta vector was analyzed.
  
  
  RESULTS
  (1) All 30 patients had a change in terminal QRS vector (elevation and/or azimuth) in comparison to postablation VCG. (2) The change of terminal QRS vector was related to delta vector and AP location. The agreement and consistency between the change of terminal QRS vector and delta vector were 91.65% and 0.856 (P < 0.01), respectively.
  
  
  CONCLUSIONS
  (1) Both initial and terminal QRS vector are affected by the antegrade conduction of AP. The change of terminal QRS vector is related to the AP location and delta vector. (2) The effect of preexcitation syndrome on QRS terminal vector is shown as more intuitive and easy in spatial vector by comparison with electrocardiogram, which is helpful for the diagnosis of atypical preexcitation and localization of AP.
authors.affiliation: Cardiovascular Institute, The First Affiliated Hospital, Liaoning Medical University, Jinzhou, Liaoning Province, China.
authors.forename: Qingru
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Cardiovascular Medicine, Weifang Traditional Chinese Hospital, Weifang, Shandong Province, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Cardiovascular Institute, The First Affiliated Hospital, Liaoning Medical University, Jinzhou, Liaoning Province, China. lijunchang0802@163.com.
authors.forename: Renguang
authors.initials: R
authors.lastname: Liu
authors.affiliation: Cardiovascular Institute, The First Affiliated Hospital, Liaoning Medical University, Jinzhou, Liaoning Province, China.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Chang
mesh_terms: D058606:Accessory Atrioventricular Bundle / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D011226:Pre-Excitation Syndromes / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014672:Vectorcardiography
keywords: QRS terminal vector; cardiology; catheter ablation; preexcitation syndrome; vectorcardiography
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