Recordings of basal ventricular preexcitation from electrode catheters in patients with accessory atrioventricular connections.

Abstract

To determnine the effects of ventricular preexcitation via accessory atrioventricular connections (ACs) on the sequence of basal ventricular activation, electrophysiologic study records of 22 patients with AC were reviewed. In each, AC site was confirmed by mapping done at operation. Local ventricular preexcitation (VP) timing of local electrograms recorded from these two ventricular sites. In addition to the physiologic insight such information provides, the pattern of local ventricular preexcitation varies with the position of the responsible accessory atrioventricular connection and therefore helps to locate the site of the pathway. Since bundle branch block (BBB) alters the sequence of ventricular activation, we also assessed its confounding effects on indexes of local ventricular preexcitation.

Mapping und Ablation bei Präexzitationssyndromen

“…Bei diesem sog. 7 antegraden Mapping zeigt sich in den lokalen bipolaren und unipolaren Elektrogrammen des Ablationskatheters ein AV-Intervall von ≤40 ms, ein Beginn der ventrikulären Aktivierung von 10-30 ms vor Beginn der δ-Welle im Oberflächen-EKG und eine scharfe negative Deflektion (QS-Komplex) im unipolaren Elektrogramm [8,36]. In einigen Fällen kann man auch zwischen atrialem und ventrikulärem Elektrogramm ein Potenzial der akzessorischen Bahn erkennen (7 AP-Potenzial ; .…”