WPW증후군 환자에서 성공적인 전극도자 절제술 후 재분극 이상
- Author(s)
- 배장호; 김윤년; 한성욱; 현대우; 신이철; 김기식; 김권배; 이상민
- Keimyung Author(s)
- Kim, Yoon Nyun; Han, Seong Wook; Kim, Kee Sik; Kim, Kwon Bae
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- 순환기
- Issued Date
- 1998
- Volume
- 28
- Issue
- 9
- Keyword
- Wolff-Parkinson-White syndrome; Repolarization abnormalities
- Abstract
- Background and Objectives:The repolarization abnormalities, after radiofrequency catheter ablation (RFCA)
of accessory pathway (AP) in patients with Wolff-Parkinson-White (WPW) syndrome, is commonly appeared
in standard 12 lead electrocardiogram (ECG) as inverted T waves. We analyzed the serial ECGs after RFCA of
AP in patients with WPW syndrome, in order to understand the repolarization abnormalities after RFCA.
Materials and Method:The study patients were consisted of ninety two patients (mean age:35 years old,
male:56 patients) out of 157 patients whose ECGs were taken at before, immediately after, one day, one, four,
eight, twelve week (s) after RFCA from December 1992 to July 1997. Results:The seventy three patients
(79%) out of ninety two patients showed the repolarization abnormalities and the thirteen patients (14%) showed
normalization of secondary T wave changes immediately after RFCA. In contrast, six patients (7%) did not show
any T wave changes after RFCA and they had left lateral AP. The lead that most frequently showed inverted T
wave changes after RFCA was lateral lead (lead I, aVL) in case of left lateral AP and inferior lead (II, III, aVF)
in case of other APs. The incidence of repolarization abnormalities after RFCA was significantly higher in patients
whose preRFCA QRS duration is longer (≥0.12 sec). The concordance rate of repolarization abnormalities
after RFCA was 86% (63 patients of 73 patients showing repolarization abnormalities after RFCA). The
normalization of repolarization abnormalities after RFCA was acquired in sixty four patients (94%) out of sixty
eight patients who showed repolarization abnormalities and followed up to twelve weeks after RFCA. The mean
time interval to the normalization of repolarization abnormalities after RFCA was 4.3±3.2 weeks. The time
interval to the normalization of repolarization abnormality after RFCA was not related with age, AP or preRFCA
QRS duration. Conclusion:The ECG lead, in which the repolarization abnormalities occurs after RFCA, is
related with the location of the AP. The repolarization abnormalities after RFCA were more common in patients
with longer preRFCA QRS duration. The repolarization abnormalities after RFCA could not be understood only
by cardiac memory. (Korean Circulation J 1998;28(9):1493-1501)
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