Arai A, Kron J
Department of Medicine, Oregon Health Sciences University School of Medicine, Portland 97201-3098.
West J Med. 1990 Apr;152(4):383-91.
The Wolff-Parkinson-White syndrome is a multifaceted disorder that ranges from asymptomatic to life threatening. Accounting for approximately 20% of cases of paroxysmal supraventricular tachycardia and with a prevalence perhaps as high as 1 per 500, it is far from a rare disorder. Considering the potentially lethal complications following the administration of digoxin or verapamil, all physicians treating arrhythmias should know when to suspect the Wolff-Parkinson-White syndrome. A careful review of electrocardiograms helps identify cases of the disorder despite a wide range of findings that may mimic other conditions. Major advances in the efficacy of surgical procedures to cure this syndrome make this a reasonable alternative to life-long medical therapy for many patients. Unfortunately, available diagnostic tests lack the positive predictive value to reliably distinguish patients at risk of sudden death. This review is an update for general internists of the major developments in the evaluation and treatment of the disorder and provides specific examples helpful in differentiating these patients.
预激综合征是一种多方面的病症，其症状从无症状到危及生命不等。它约占阵发性室上性心动过速病例的20%，患病率可能高达每500人中有1例，远非罕见病症。鉴于使用地高辛或维拉帕米后可能出现致命并发症，所有治疗心律失常的医生都应知道何时怀疑患有预激综合征。尽管心电图表现广泛，可能类似其他病症，但仔细查看心电图有助于识别该病症的病例。治疗该综合征的外科手术疗效取得了重大进展，这使得手术成为许多患者替代终身药物治疗的合理选择。不幸的是，现有的诊断测试缺乏可靠区分有猝死风险患者的阳性预测价值。本综述是为普通内科医生提供的该病症评估和治疗主要进展的最新信息，并提供有助于鉴别这些患者的具体实例。
