Abstract:Pre-excitation syndrome is an electrocardiographic pattern in which all or part of the ventricular muscles can be activated sooner than normal due to atrial activation by accessory pathway. The existence of the bundle of Kent contributes to formation of the classic preexcitation syndrome (the socalled Wolff Parkinson White syndrome, WPW syndrome), with an incidence rate of about 0.1‰-0.3‰ and 7%-20% of these patients are complicated with other congenital heart diseases(such as Ebstein’s anomaly). WPW syndrome can be categoried by manifest pre-excitation, intermittent pre-excitation, incomplete latent pre-excitation, latent pre-excitation and concealed pre-excitation. Tachyarrhythmia related to WPW syndrome includes atrioventricular reentrant tachycardia and atrial ectopic activation down the ventricle through accessory pathway.The existence of pre-excitation could probably make it harder for ECG diagnosis of some diseases. For example, pre-excitation is always exactly like or conceals myocardial infarction or bundle branch block and so on. Therefore, elimination of δ wave could help in differential diagnosis.Generally, pre-excitation syndrome has a good prognosis and radiofrequency ablation has become a preferred treatment.
[1] AlKhatib S M, Pritchett E L C. Clinical features of WolffParkinsonWhite syndrome[J]. Am Heart J, 1999, 138(3):403-413.[2] 李莉, 刘敏, 杨俊, 等. 预激综合征与遗传[J]. 中国老年学杂志, 2011, 31(9):1705-1706.[3] 罗亚雄, 王福军. 预激综合征的用药策略[J]. 江苏实用心电学杂志, 2012, 21(5):357-366.[4] 刘仁光, 徐兆龙. 预激综合征心电图学研究进展[J]. 岭南心血管病杂志, 2011, 17(2): 89-91,99.[5] Smolders L, Majidi M, Krucoff M W, et al. Preexcitation and myocardial infarction: conditions with confusing electrocardiographic manifestations[J].J Electrocardiol, 2008, 41(6): 679-682.[6] Hasegawa K, Sato A, Watanabe H, et al. Early repolarization and its modification by preexcitation in two patients with intermittent WolffParkinsonWhite syndrome[J]. Pacing and Clinical Electrophysiology, 2012, 35(8):e231-e233.[7] 许原. 食管心房调搏[M]. 北京:北京大学医学出版社,2010:128-136.[8] Mine T, Kodani T, Hamaoka M, et al. An asymptomatic case of WolffParkinsonWhite syndrome with rightsided freewall accessory pathway and left ventricular dysfunction[J]. Journal of Arrhythmia, 2011, 27(2):145-149. [9] CadrinTourigny J,Fournier A, Andelfinger G, et al. Severe left ventricular dysfunction in infants with ventricular preexcitation[J]. Heart Rhythm,2008, 5(9): 1320-1322.[10] Fukunaga H, Akimoto K, Furukawa T, et al. Improvement in nontachycardiainduced cardiac failure after radiofrequency catheter ablation in a child with a rightsided accessory pathway[EB/OL]. Heart and Vessels, 10.1007/s00380-013-0322-5/2013-02,http://link.springer.com/article/10.1007%2Fs00380-013-0322-5/2013-04-22.