[Localization of accessory atrioventricular pathways in patients with manifest premature ventricular excitation syndrome by three-dimensional vector electrocardiography].

Distribution of excitation via ventricular myocardium in patients with accessory atrioventricular pathways (AAVP) was studied using three-dimensional vector ECG. Analysis of the ECGs obtained during the study formed new views on the excitation process in the myocardium in the presence of AAVP, and made it possible to formulate vector ECG (VECG) criteria of AAVP localization. In 30 cases out of 33 it was possible to correctly localize AAVP. Information obtained as a result of VECG analysis made it possible to localize AAVP preoperatively within the limits of 1/14th atrioventricular sulcus with 97.1% accuracy, which is substantially higher than the accuracy of conventional electrocardiographic algorithms. Thus, the study found that in some cases three-dimensional vector ECG allows for substantial increase in the validity of AAVP localization, while in others it is the only sensitive non-invasive method of topical diagnostics of manifest premature ventricular excitation syndrome. Knowledge of the character of intervector interaction during ventricular electric systole makes it possible to predict the character of changes in the trajectory of QRS vector loop in any AAVP localization, i.e. to model the vector loop.

[10-year experience with correction of supraventricular tachycardia]. / Desiatiletnii opyt korrektsii nadzheludochkovykh takhiaritmii.

The results of a 10-year experience in surgical treatment of supraventricular tachyarrhythmias in 258 patients are analysed. Invasive and noninvasive methods of electrophysiological studies with the predominant use of Soviet-produced apparatuses were employed in establishing the diagnosis. Surgery of arrhythmias included catheter destruction, cryosurgery on a working heart, but the prevailing methods were various types of destruction of anomalous conducting paths under conditions of extracorporeal circulation. The authors suggest a method for dosed electrocoagulation of paranodal tissues in atrioventricular nodal tachycardias. The results of the operation were positive in over 90% of cases. Three fatal outcomes in operations with extracorporeal circulation occurred during the first years of accumulation of experience in the method. It is concluded that the operation is highly effective in severe tachyarrhythmias.