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Cardiac Electrophysiology Clinics Dec 2020
Topics: Electrocardiography; Humans; Pre-Excitation Syndromes
PubMed: 33162006
DOI: 10.1016/j.ccep.2020.09.002 -
Pacing and Clinical Electrophysiology :... Jul 2018Many recent recommendations concern the management of preexcitation syndrome. In clinical practice, they are sometimes difficult to use. The purpose of the authors was... (Review)
Review
Many recent recommendations concern the management of preexcitation syndrome. In clinical practice, they are sometimes difficult to use. The purpose of the authors was to discuss the main problems associated with this management. Three problems are encountered: (1) the reality of the absence of symptoms or the interpretation of atypical symptoms, (2) the electrocardiographic diagnosis of preexcitation syndrome that can be missed, and (3) the exact electrophysiological protocol and its interpretation used for the evaluation of the prognosis. Because of significant progress largely related to the development of curative treatment, it seems easy to propose ablation in many patients despite the related risks of invasive studies and to minimize the invasive risk by only performing ablation for patients with at-risk pathways. However, there is a low risk of spontaneous events in truly asymptomatic patients and the indication of accessory pathway ablation should be discussed case by case.
Topics: Humans; Pre-Excitation Syndromes
PubMed: 29754436
DOI: 10.1111/pace.13367 -
Current Problems in Cardiology Mar 2016The classic electrocardiogram in Wolff-Parkinson-White (WPW) syndrome is characterized by a short PR interval and prolonged QRS duration in the presence of sinus rhythm... (Review)
Review
The classic electrocardiogram in Wolff-Parkinson-White (WPW) syndrome is characterized by a short PR interval and prolonged QRS duration in the presence of sinus rhythm with initial slurring. The clinical syndrome associated with above electrocardiogram finding and the history of paroxysmal supraventricular tachycardia is referred to as Wolff-Parkinson-White syndrome. Various eponyms describing accessory or anomalous conduction pathways in addition to the normal pathway are collectively referred to as preexcitation syndromes. The latter form and associated eponyms are frequently used in literature despite controversy and disagreements over their actual anatomical existence and electrophysiological significance. This communication highlights inherent deficiencies in the knowledge that has existed since the use of such eponyms began. With the advent of curative ablation, initially surgical, and then catheter based, the knowledge gaps have been mostly filled with better delineation of the anatomic and electrophysiological properties of anomalous atrioventricular pathways. It seems reasonable, therefore, to revisit the clinical and electrophysiologic role of preexcitation syndromes in current practice.
Topics: Atrial Flutter; Atrioventricular Node; Catheter Ablation; Electrocardiography; Humans; Pre-Excitation Syndromes; Wolff-Parkinson-White Syndrome
PubMed: 26897561
DOI: 10.1016/j.cpcardiol.2015.11.002 -
Current Opinion in Cardiology May 2002Genetic studies of families with inherited cardiac rhythm disturbances have established a molecular basis for ventricular arrhythmogenic disorders. Genes responsible for... (Review)
Review
Genetic studies of families with inherited cardiac rhythm disturbances have established a molecular basis for ventricular arrhythmogenic disorders. Genes responsible for the long QT syndrome, Brugada syndrome, and polymorphic ventricular tachycardia have been identified. The elucidation of genetic defects responsible for more commonly occurring supraventricular rhythm disturbances have not been as forthcoming, with the exception of SCN5A mutations known to cause conduction system disease. Recently, we identified the genetic cause of a familial arrhythmogenic syndrome characterized by ventricular preexcitation and tachyarrhythmias (Wolff-Parkinson-White syndrome), progressive conduction system disease, and cardiac hypertrophy. The causative gene was shown to be the gamma-2 regulatory subunit (PRKAG2) of AMP-activated protein kinase. The role of AMP-activated protein kinase in the regulation of the glucose metabolic pathway in muscle suggests that genetic defects in PRKAG2 may induce a previously undescribed cardiac glycogenosis syndrome.
Topics: AMP-Activated Protein Kinases; Adult; Cardiomegaly; Gene Expression Regulation, Enzymologic; Genetic Predisposition to Disease; Heart Conduction System; Humans; Male; Multienzyme Complexes; Pre-Excitation Syndromes; Protein Serine-Threonine Kinases
PubMed: 12015471
DOI: 10.1097/00001573-200205000-00004 -
BMC Cardiovascular Disorders May 2018Preexcitation syndrome is characterized by a dominant delta wave on the baseline electrocardiogram (ECG), resulting from the change in QRS initial vector by the...
BACKGROUND
Preexcitation syndrome is characterized by a dominant delta wave on the baseline electrocardiogram (ECG), resulting from the change in QRS initial vector by the accessory pathway (AP). This study is to explore the effect of ventricular preexcitation on the QRS initial, maximal and terminal vector in an experimental rabbit with preexcitation syndrome induced by programmed electrical stimulation.
METHODS
Rabbits (n = 10) were randomized for the experimental model of ventricular preexcitation. Sensing and stimulating electrode catheters were placed in the high right atrium and along epicardial surface of atrioventricular groove of the left ventricular anterior wall, respectively. Programmed premature stimulation S was synchronized with P wave and utilized to stimulate the ventricle. The ECG recorded the electrical activity of the heart. As compared with the QRS complex during sinus rhythm, paced QRS was assessed regarding the initial, maximal and terminal vector. PS interval and PR interval were also measured and analyzed.
RESULTS
Preexcitation was successfully simulated by ventricular pacing in the rabbits, including (1) Complete preexcitation: PS interval was less than PR interval; the difference was more than or equal to 47.00 ± 7.53 ms. (2) Incomplete preexcitation: PS interval was less than PR interval; the difference was less than 47.00 ± 7.53 ms. (3) Incomplete latent preexcitation: PS interval was more than or equal to PR interval; the difference was less than or equal to 13.00 ± 3.50 ms. (4) Complete latent preexcitation: PS interval was more than or equal to PR interval; the difference was more than 13.00 ± 3.50 ms.
CONCLUSIONS
The difference in the relative conduction velocity of the atrioventricular node versus the AP pathways determines the degree of preexcitation and different manifestation on ECG. The QRS terminal vector also reflects the ventricle preexcitation, indicating a valuable sign for the diagnosis of atypical or latent preexcitation.
Topics: Accessory Atrioventricular Bundle; Action Potentials; Animals; Atrioventricular Node; Cardiac Pacing, Artificial; Disease Models, Animal; Electrocardiography; Heart Rate; Heart Ventricles; Pre-Excitation Syndromes; Predictive Value of Tests; Rabbits; Time Factors
PubMed: 29783947
DOI: 10.1186/s12872-018-0836-y -
American Journal of Critical Care : An... Sep 2021
Topics: Angina Pectoris; Confounding Factors, Epidemiologic; Electrocardiography; Humans; Pre-Excitation Syndromes
PubMed: 34467376
DOI: 10.4037/ajcc2021713 -
Ryoikibetsu Shokogun Shirizu 1996
Review
Topics: Electrocardiography; Humans; Pre-Excitation Syndromes; Wolff-Parkinson-White Syndrome
PubMed: 9047486
DOI: No ID Found -
Journal of Electrocardiology Jul 1991During the course of investigation for palpitations, a 62-year-old man underwent exercise testing using a MARQUETTE CASE 12 computerized exercise testing system. By...
During the course of investigation for palpitations, a 62-year-old man underwent exercise testing using a MARQUETTE CASE 12 computerized exercise testing system. By stage III of the modified Bruce protocol, the computer-generated electrocardiogram appeared to show the development of exercise-induced preexcitation. Closer examination of the raw unfiltered data showed this to be a computer-generated artifact rather than true preexcitation. This artifact arose due to inherent limitations common to all computerized exercise testing systems and emphasizes the need to always review raw data, even when a seemingly clear-cut abnormality is present on a computer-averaged electrocardiogram.
Topics: Artifacts; Electrocardiography; Exercise Test; Humans; Male; Middle Aged; Pre-Excitation Syndromes
PubMed: 1919386
DOI: 10.1016/0022-0736(91)90032-h -
Developmental Period Medicine 2018Preexcitation syndromes are becoming a more often detected disease in the pediatric population. Their essential feature is the presence of additional paths / pathways in... (Review)
Review
Preexcitation syndromes are becoming a more often detected disease in the pediatric population. Their essential feature is the presence of additional paths / pathways in the heart, through which the impulse is conducted faster than physiologically. This leads to faster ventricular excitation and may lead to creating dangerous arrhythmias. The most common preexcitation syndrome is Wolff - Parkinson-White syndrome, which affects 2/ 1000 people. The presence of an accessory pathway could result in serious consequences, ranging from supraventricular tachycardia to sudden cardiac death. There are both invasive and non-invasive methods of diagnosing preexcitation syndromes. Therapeutic treatment includes pharmacotherapy and ablation, which makes it possible to permanently remove the cause of the arrhythmia.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Male; Pre-Excitation Syndromes; Wolff-Parkinson-White Syndrome
PubMed: 30056405
DOI: 10.34763/devperiodmed.20182202.179186 -
Circulation. Arrhythmia and... Nov 2023
Topics: Humans; Animals; Columbidae; Hawks; Accessory Atrioventricular Bundle; Pre-Excitation Syndromes; Cardiomyopathy, Hypertrophic
PubMed: 37920987
DOI: 10.1161/CIRCEP.123.012543