Bhatia Atul, Sra Jasbir, Akhtar Masood
Curr Probl Cardiol. 2016 Mar;41(3):99-137. doi: 10.1016/j.cpcardiol.2015.11.002. Epub 2015 Nov 10.
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.
预激综合征的典型心电图表现为窦性心律时PR间期缩短、QRS波时限延长且起始部有顿挫。与上述心电图表现及阵发性室上性心动过速病史相关的临床综合征称为预激综合征。除正常传导途径外,各种描述附加或异常传导途径的病名统称为预激综合征。尽管对于这些附加或异常传导途径的实际解剖学存在及电生理意义存在争议和分歧,但后一种形式及相关病名在文献中仍经常被使用。本文强调了自使用此类病名以来一直存在的知识固有缺陷。随着根治性消融技术的出现,最初是外科手术,然后是导管消融,通过更好地描绘异常房室传导途径的解剖和电生理特性,大部分知识空白已被填补。因此,在当前实践中重新审视预激综合征的临床和电生理作用似乎是合理的。