Nicolai P, Medvedowsky J L, Dlaage M, Barnay C, Blache E, Guiraudon G, Frank R, Fontaine G
Arch Mal Coeur Vaiss. 1977 Nov;70(11):1173-82.
The authors report the case of a man of 22 years, with no previous cardiac history, in whom a Wolff-Parkinson-White syndrome was discovered during the course of this first episode of atrial fibrillation with a ventricular rate of 300-350/mn; investigation (vecto-cardiogram, intra-cavitory ECG) showed the presence of a short circuit of the Kent type, with a high permeability, and localised in the left lateral position; this was confirmed by pericardial cartography. After the surgical division of the accessory pathway, the electrical phenomenon of pre-excitation disappeared. The current possibilities of operating on cases of a Wolff-Parkinson-White syndrome justify carrying out a scrupulous electrophysiological study of each case, so that any accessory pathway can be precisely localised, and its refractory period determined; thus a pathway of preexcitation localised in the left lateral position, and having a short refractory period leading to a high ventricular rate under atrial fibrillation conditions, constitutes an indication for operation which may be urgent.
作者报告了一例22岁男性病例，该患者既往无心脏病史，在首次房颤发作且心室率为300 - 350次/分钟的过程中发现了预激综合征；检查（心向量图、心腔内心电图）显示存在肯特（Kent）型短路，具有高传导性，位于左侧；心包标测证实了这一点。在手术切断附加通路后，预激的电现象消失。目前对预激综合征病例进行手术的可能性使得有必要对每例患者进行细致的电生理研究，以便能精确地定位任何附加通路，并确定其不应期；因此，位于左侧且不应期短、在房颤情况下导致高心室率的预激通路构成了可能紧急手术的指征。
