German L D, Gallagher J J
Am J Med. 1984 Jun;76(6):1079-86. doi: 10.1016/0002-9343(84)90862-3.
The Wolff-Parkinson-White syndrome is an uncommon cardiac disorder due to the presence of an accessory atrioventricular pathway resulting in ventricular pre-excitation and supraventricular tachycardias. The recognition of the Wolff-Parkinson-White syndrome is important because of the potential for the development of extremely rapid ventricular rates during atrial fibrillation that may lead to ventricular fibrillation and sudden death. The diagnosis of the Wolff-Parkinson-White syndrome is obvious when classic delta waves and short P-R intervals are present, but the electrocardiographic manifestations of the syndrome may be subtle and vary considerably from patient to patient. Certain commonly used antiarrhythmic medications may be useful for the treatment of reciprocating tachycardia in these patients and yet prove to be ineffective--or even deleterious--in preventing excessively rapid conduction to the ventricles during atrial fibrillation. An appreciation of the functional properties of the accessory pathways in the Wolff-Parkinson-White syndrome and how they are affected by pharmacologic agents should result in improved recognition of this entity and more effective medical management of patients with a risk of sudden death.
预激综合征是一种不常见的心脏疾病，由于存在房室旁道，导致心室预激和室上性心动过速。认识预激综合征很重要，因为房颤时心室率可能极快，进而可能导致心室颤动和猝死。当出现典型的delta波和短P-R间期时，预激综合征的诊断很明显，但该综合征的心电图表现可能很细微，且个体差异很大。某些常用的抗心律失常药物可能对治疗这些患者的折返性心动过速有用，但在预防房颤时心室过度快速传导方面可能无效，甚至有害。了解预激综合征中旁道的功能特性以及它们如何受到药物影响，应能提高对该疾病的认识，并对有猝死风险的患者进行更有效的药物治疗。
