Unresolved Issues in Evaluation and Treatment of Preexcitation Syndromes
The preexcitation syndromes have been the subject of extensive study, particularly during the last two decades. As a result, we have derived an understanding of both the anatomic substrates of the syndromes and the pathophysiology of its related tachyarrhythmias which far exceeds that of any other disorder associated with cardiac rhythm disturbances. Further, techniques for the precise analysis of the rhythm disorders associated with the preexcitation syndromes have been developed, and a relatively extensive medical and surgical armamentarium for treatment and in some instances of apparent cure of the underlying problem has resulted. Nonetheless, many aspects of the preexcitation syndromes remain to be explored and clarified. The purpose of this chapter is to highlight certain elements of these syndromes in which the final word is not yet in. The list is certainly not comprehensive. However, we hope that it will provide a stimulus for further study of a number of clinically pertinent issues, ultimately leading to both greater insight into these syndromes on the part of interested physicians and scientists and better treatment for patients.
KeywordsAtrial Fibrillation Antiarrhythmic Drug Accessory Pathway Effective Refractory Period Versus Connection
Unable to display preview. Download preview PDF.
- 1.Gettes LS, Zipes DP, Gillette PC, Josephson ME, Laks MM, Mirvis DM, Scheinman MM, Sheffield LT, Wu D: Personnel and equipment required for electrophysiologic testing. Report of the committee on electrocardiography and cardiac electrophysiology, council on clinical cardiology, The American Heart Association. Circulation 69: 1219A, 1984.Google Scholar
- 4.Prystowsky EN, Miles WM, Heger JJ, Zipes DP: Preexcitation syndromes. Mechanisms and management. Med. Clin. N. 68: 831, 1984.Google Scholar
- 5.5.Lévy S, Broustet J-P, Clementy J, Vircoulon B, Bricaud H, Gerard R: Value of noninvasive techniques in the Wolff-Parkinson-White syndrome with particular reference to exercise testing. In Cardiac Arrhythmias: From Diagnosis to Treatment. Lévy S, Scheinman MM, (eds.). Futura, Mont Kisco, 1984, pp. 301–312.Google Scholar
- 11.Wells JL, Karp RB, Kouchoukos NT, Maclean WAH, James TN, Waldo AL: Characterization of atrial fibrillation in man: Studies following open heart surgery. PACE 1: 426, 1978.Google Scholar
- 18.Petri H, Kafka W, Hall D, Rudolph W: Potential acceleration of the ventricular rate in WolffParkinson-White syndrome with atrial fibrillation after verapamil. (Abstract.) Circulation 62 (Supp II): 262, 1980.Google Scholar
- 19.Gallagher JJ, Sealy WC, Cox JL, Kasell JH: Results of surgery for preexcitation in 200 con-552 VI. FUTURE PROSPECTS secutive cases. In Cardiac Arrhythmias: From Diagnosis to Therapy. Lévy S, Scheinman MM, (eds.). Futura, Mount Kisco, 1984, pp. 323–340.Google Scholar
- 24.Waldo AL, Plumb VJ, Arciniegas JG, MacLean WAH, Cooper TB, Priest MF, James TN: Transient entrainment and interruption of the atrioventricular bypass pathway type of paroxysmal atrial tachycardia. A model for understanding and identifying reentrant arrhythmias. Circulation 67: 73, 1983.PubMedCrossRefGoogle Scholar