Activation-recovery intervals of 12-lead electrocardiograms before and after catheter ablation in patients with Wolff-Parkinson-White syndrome

Preexcitation in Wolff-Parkinson-White syndrome (WPW) has been reported to induce long-lasting changes in ventricular recovery properties. However, th ere has not been a report concerning changes in the activation-recovery int erval (ARI) in 12-lead ECGs before and after catheter ablation (CA) in pati ents with WPW syndrome. The present study compared changes in ARIs from 12- lead ECGs with those from body surface unipolar leads before and after CA t o examine whether ARIs from limb leads of 12-lead ECGs provide useful infor mation on changes in recovery properties in addition to the ARIs from preco rdial leads. The study population consisted of 27 manifest WPW patients wit h a left- (n=18, group A) or right-sided accessory pathway (n=9, group B). ARIs in leads I, II, and III were strongly correlated with those in unipola r leads over the left lateral, left lower, and right lower chest, respectiv ely. ARIs in leads aVR, aVL, and aVF showed a significant correlation with those in unipolar leads over the right upper, left upper, and lower anterio r chest, respectively. These correlations were maintained before and after CA. Furthermore, in group A, ARIs in lead VI tended to increase on day 7 po st CA compared with before CA and on day 1. In group B, ARIs in lead III si gnificantly decreased on day 7 compared with before CA and on day 1. These findings suggest that ARIs from the limb leads of 12-lead ECGs may represen t those from unipolar leads of a particular area over the body surface, and that ARIs from 12-lead ECGs may provide useful quantitative information on changes in recovery properties before and after CA in patients with manife st WPW syndrome.