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[预激综合征的历史及其治疗方法的外科演变]

[The history of Wolf-Parkinson-White syndrome and evolution of surgical methods for its management].

作者信息

Bokeriia L A, Revishvili A Sh, Melikulov A Kh, Le T G, Khusainov R Kh, Glushko L A

出版信息

Vestn Ross Akad Med Nauk. 2009(12):16-21.

Abstract

Wolf-Parkinson-White syndrome (WPW syndrome) affects roughly 1% of the population. It usually occurs in subjects with normal heart function but may combine with congenital cardiac failure and cardiomyopathy. Paroxysmal tachycardia is recorded in 40-80% of he WPW patients, largely in the form of reciprocal tachycardia related to circulation of excitation in the atrioventricular junction and Kent's bundle. Development and improvement of surgical methods for the management of supraventricular tachycardia became possible with the advent of transcatheter registration of electrical activity in different heart regions and programmed heart stimulation techniques. Catheter-assisted methods for the treatment of cardiovascular disorders including arrhythmia have been extensively used in recent decades. Transvenous fulguration is one of them replaced at present by radiofrequency ablation (RFA). The discovery of WPW syndrome made possible a new approach to the the problem of sudden death in young age. Treatment of this syndrome by RFA of additional atrioventricular junction in the last 20 years permitted not only to manage the syndrome itself but also to ensure practically complete recovery of the patients.

摘要

预激综合征(WPW综合征)约影响1%的人群。它通常发生在心脏功能正常的个体中,但也可能与先天性心力衰竭和心肌病并存。40%-80%的WPW患者会出现阵发性心动过速,主要表现为与房室交界区和肯特束内兴奋循环相关的折返性心动过速。随着不同心脏区域电活动的经导管记录和心脏程控刺激技术的出现,室上性心动过速外科治疗方法得以发展和完善。近几十年来,包括心律失常在内的心血管疾病的导管辅助治疗方法得到了广泛应用。经静脉电凝是其中一种方法,目前已被射频消融(RFA)所取代。WPW综合征的发现为解决年轻人群猝死问题提供了新途径。在过去20年中,通过对额外房室交界区进行RFA治疗该综合征,不仅能够控制综合征本身,还能确保患者几乎完全康复。

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