Hamer S S, Lemberg L
Heart Lung. 1977 Mar-Apr;6(2):344-8.
Concealed WPW is a newly described clinical entity. The existence of this syndrome can be ascertained only through specific electrophysiologic intracardiac studies. From the clinical standpoint, the existence of an accessory unidirectional A-V pathway anatomically located in the general area of the Kent bundle should be suspected in those patients with chronic BBB who have recurrent paroxysmal atrial tachycardias initiated by sinus arrhythmias or premature atrial beats. It should be noted that functional BBB can occur following a premature atrial beat. This will also set the stage for the initiation of a reciprocating tachycardia in concealed WPW. Pharmacological therapy aimed at preventing the recurrent tachycardias is disappointing. Pacemaker implantation appears to be successful by rendering one of the bundle branches refractory through concealed conduction. With chronic block of the remaining bundle branch, the natural pathway of A-V conduction is totally blocked at a critical time during the tachycardias, thus eliminating the reciprocating tachycardia.
隐匿性预激综合征是一种新描述的临床实体。只有通过特定的心内电生理研究才能确定该综合征的存在。从临床角度来看，对于那些患有慢性束支传导阻滞且由窦性心律失常或房性早搏引发反复阵发性房性心动过速的患者，应怀疑存在解剖位置在肯特束大致区域的附加单向房室通路。应当注意，房性早搏后可出现功能性束支传导阻滞。这也将为隐匿性预激综合征中折返性心动过速的发作创造条件。旨在预防反复心动过速的药物治疗效果不佳。起搏器植入似乎是成功的，通过隐匿性传导使其中一支束支产生不应期。随着剩余束支的慢性阻滞，房室传导的自然通路在心动过速期间的关键时间完全被阻断，从而消除折返性心动过速。
