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Radiofrequency ablation of accessory pathways in patients with WPW syndrome on left ventricular systolic synchrony

Author: ZuoChangQing
Tutor: ChenChun
School: Nanjing Medical University
Course: Internal Medicine
Keywords: Myocardial perfusion imaging Phase analysis LV is not synchronized WPW syndrome Radiofrequency catheter ablation Radiofrequency ablation
CLC: R541.7
Type: Master's thesis
Year: 2011
Downloads: 7
Quote: 0
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Abstract


Purpose of the use of gated SPECT myocardial perfusion imaging (GSPECT MPI) Phase Analysis Techniques radiofrequency ablation (RFCA) for blocking the bypass WPW syndrome (WPW) in patients with left ventricular systolic synchrony. Methods 44 patients enrolled, including 35 cases in RFCA before surgery, 2-3 days for GSPECT MPI phase analysis. Electrophysiological examination determined according to bypass parts of the patient classification (interval group, group left free wall, right free wall group). MPI data through the phase analysis to assess preoperative and postoperative RFCA WPW patients left ventricular systolic synchrony. Results septal bypass group than in the free wall of the left or right next to the road preoperative left ventricular dyssynchrony more pronounced (p lt; 0.05). In all patients and in patients with ventricular septal pathways, RFCA postoperative left ventricular dyssynchrony improvement (p lt; 0.01). Conclusion GSPECT MPI phase analysis showed that patients with left ventricular systolic WPW mechanical dyssynchrony, especially in patients with septal pathways systolic mechanical dyssynchrony is more obvious, RFCA by successfully blocking the bypass and improved left ventricular systolic synchrony. This study suggests that can be combined with electrophysiological techniques and GSPECT MPI phase analysis techniques on cardiac electrical and mechanical activity excitement further explored the relationship between research. Objective Using quantitative tissue velocity imaging (QTVI) radiofrequency ablation (RFCA) blocking the bypass of the pre-excitation syndrome (WPW) in patients with left ventricular systolic synchrony. Methods 17 patients with WPW syndrome in RFCA for preoperative and postoperative echocardiography 1-2, obtain the standard four-chamber, two chambers, left ventricular long axis view, the application of quantitative tissue velocity imaging (QTVI ) for left ventricular segmental myocardial tissue Doppler velocity curves were measured in each segment time to peak systolic longitudinal velocity (Ts), calculate the standard deviation of 12 segments Ts (Ts-12-SD) for left ventricular systolic not coincident indicators. With Ts-12-SD gt; 33ms left ventricular systolic mechanical dyssynchrony criteria, patients were divided into groups of left ventricular and left ventricular synchronization sync group. Results All 17 cases of patients enrolled RFCA preoperative electrocardiogram clear \not synchronized group, left ventricular synchronization group, preoperative and postoperative QRS complex time and standard 12-lead ECG QRS wave area and were statistically significant (P lt; 0.05), postoperative QRS wave time were shortened and standard 12-lead QRS complex area and are associated decreases. With Ts-12-SD gt; 33ms left ventricular mechanical dyssynchrony criteria, RFCA preoperative left ventricular unsynchronized incidence 58.8% (10/17) in all 17 patients and left ventricular sync group, RFCA surgery before and after Ts-12-SD was statistically significant, are not synchronized to improve postoperative left ventricular (P lt; 0.05). Left ventricular synchronization group, RFCA preoperative and postoperative Ts-12-SD was not statistically significant (P gt; 0.05). Conclusion Radiofrequency ablation successfully blocking the bypass can improve left ventricular dyssynchrony in patients with WPW.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Arrhythmia
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