Non-Invasive Diagnosis of Concealed Wolff-Parkinson-White Syndrome by Detection of Concealed Anterograde Pre-Excitation
スポンサーリンク
概要
- 論文の詳細を見る
Electrophysiological findings suggest that concealed anterograde conduction through accessory pathways may exist even during sinus rhythm in patients with so-called concealed Wolff-Parkinson-White (WPW) syndrome. To evaluate the pre-excitation characteristics in various types of WPW syndrome, high-resolution electrocardiograms were analyzed in 81 consecutive WPW syndrome patients and 50 age-matched normal subjects. The WPW group consisted of 30 cases of concealed WPW diagnosed by electrophysiological study, 38 cases of manifest WPW in which apparent delta waves were constant, and 13 cases of intermittent WPW in which the delta waves appeared periodically. The duration of the low-amplitude, high-frequency components of the signal-averaged filtered QRS complex that preceded the earliest upstroke of the surface QRS, including any delta waves (preceding potential duration, PPD), and the duration of low amplitude signals less than 10μV (I-LAS10) or 20μV (I-LAS20) were measured as parameters of pre-excitation. The PPDs in concealed and intermittent WPW were both significantly longer than in manifest WPW or in control subjects (6.8±2.7 ms, 7.9±3.5 ms vs 2.3±3.2 ms, 1.0±1.6 ms, both p<0.0001). Abnormally prolonged PPDs (>4 ms) were observed in 90% of concealed WPW cases and 76.9% of intermittent WPW, but in only 4% of normal subjects and 31.6% of manifest WPW. Both I-LAS10 and I-LAS20 in the 3 types of WPW syndrome were significantly longer than in normal subjects. The initial portion of the filtered QRS in concealed WPW closely resembled that of intermittent WPW. These results strongly suggest that in concealed WPW anterograde conduction through accessory pathways does occur and produces small amounts of pre-excitation even during sinus rhythm. The study concluded that, despite its name, concealed WPW is not completely concealed, and that non-invasive diagnosis during sinus rhythm is possible by using high-resolution electrocardiography to detect the concealed anterograde pre-excitation.
- 社団法人日本循環器学会の論文
- 2001-04-20
著者
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Tanaka K
The First Department Of Internal Medicine Nippon Medical School
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Hayakawa Hirokazu
The First Department of Internal Medicine, Nippon Medical School
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Katoh Takao
The First Department of Internal Medicine, Nippon Medical School, Tokyo Japan Organizing Members of
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Ohara Toshihiko
The First Department of Internal Medicine, Nippon Medical School
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Hayakawa Hirokazu
The First Department Of Medicine Nippon Medical School
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Hayakawa Hirokazu
Internal Medicine Department Of Cardiology Nippon Medical School
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Hayakawa Hirokazu
The First Department Of Internal Medicine Nippon Medical School
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Kim Eung
The First Department of Internal Medicine, Nippon Medical School
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Kim Eung
The First Department Of Internal Medicine Nippon Medical School
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Katoh Takao
The First Department Of Internal Medicine Nippon Medical School
-
Ohara Toshihiko
The First Department Of Internal Medicine Nippon Medical School
-
Kim Eungmoon
The 1st Department Of Internal Medicine Nippon Medical School
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Hayakawa Hirokazu
The 1st Department Of Internal Medicine Nippon Medical School
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Honma Hiroshi
Department Of Physiological Laboratory Nippon Medical School
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Hayashi Hiromitsu
Department Of Radiology Graduate School Of Radiology Nippon Medical School
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Honma Hiroshi
Division Of Cardiology Hepatology Geriatrics And Integrated Medicine Department Of Internal Medicine
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Hayakawa Hirokazu
First Dept Of Internal Medicine Nippon Medical School
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Katoh Takao
Intensive And Coronary Care Unit Nippon Medical School
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