Measured Body Surface Potentials Icon Pre-stimulated Bypass Study

Objective To evaluate the accuracy of body surface potential mapping (BSPM) in localizing overt accessory pathway (AP), and to probe its methodology and technique. Materials and Methods 41patients with manifest WPW syndrome, who were given radiofrequency ablation therapies, underwent BSPM and synchronous 12-lead electrocardiography examination before and after RFCA. Both BSPM and ECG were recorded in patients with intermittent WPW syndrome and with small delta wave WPW syndrome by means of esophageal pacing. The results were compared with the target point of precisely endocardiac electrophysiological mapping. Results It revealed that the complete agreement of BSPM with the target point of endocardial mapping was 82.9%, whereas ECG was64.4% (P<0.05). The incomplete agreement of BSPM with the target point of endocardial mapping was95.1%, ECG was 85.3% (P>0.05). The complete agreement rates of localizing the free AP was 86.7% by BSPM, whereas the septal AP was 66.7% (P>0.05); The complete agreement rates of localizing the free AP was 73.7% by BSPM, whereas the septal AP was 33.3% (P<0.05). The complete rates of determining the left-sided AP was 87.1% by BSPM, however the right-sided AP 72.7% (P>0.05). Compared with target point of endocardial mapping. It is more accurate for BSPM and ECG to localize the AP in 15 patients with intermittent WPW syndrome or with small delta wave WPW syndrome by means of esophageal pacing. Fortunately, we identify two AP in a patient with WPW syndromemore correctly, and accurately determine the AP in four patients with WPW syndrome suffering from bundle branch block. Conclusions (1) As a new noninvasive examination of high efficiency, simple, security and easy repeating, BSPM may be more accurate in localizing the overt AP, and could be an important supplement of routine synchronous 12-leadelectrocardiogeaphy. (2) The accuracy of BSPM in determining AP might be improved through attaching importance to the key methodology. (3) Confirming the complicated AP, BSPM may be more accurate than ECG.