Japanese Heart Journal
Online ISSN : 1348-673X
Print ISSN : 0021-4868
ISSN-L : 0021-4868
Comparison of Vectorcardiographic and 12-lead Electrocardiographic Detections of Abnormalities in Repolarization Properties due to Preexcitation in Patients with Wolff-Parkinson-White Syndrome
Proposal of a Novel Concept of a "Remodeling Gradient"
Sugino MikioInden YasuyaSawada TakahisaTsuboi NaoyaHirayama HaruoIto TeruoShimizu AtsuyaIino ShigeoYoshida YukihikoAkahoshi MakotoKondo TakahisaHirai MakotoSaito Hidehiko
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2000 Volume 41 Issue 3 Pages 295-312

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Abstract

Repolarization abnormalities after radiofrequency ablation in patients with manifest Wolff-Parkinson-White syndrome (WPW) have been attributed to cardiac memory of preexisting changes in repolarization properties. We compared spatial ventricular gradient (VG) from vectorcardiograms with QRST values of 12-lead ECG in 41 patients with WPW (group A, manifest WPW due to left-sided accessory pathway (n = 20); group B, manifest WPW due to right-sided accessory pathway (n = 12); group C, concealed WPW (n = 9)) before and after ablation. Group N (n = 607) served as control. In groups A and B, the abnormalities of spatial VG and QRST values of 12-lead ECG that existed before and 1 day after ablation significantly decreased 1 week after ablation. In group C, spatial VG and QRST values of 12-lead ECG showed no significant changes. The diagnostic ability of spatial VG is almost equivalent to that of the QRST value of ECG in detecting repolarization abnormalities in patients with WPW before and after ablation. We propose a new concept of a "remodeling gradient" directing from the preexcited area to the opposite side of the ventricle as a result of preexcitation-induced electrical remodeling.

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© 2000 by the Japanese Heart Journal
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