Morady F, Sledge C, Shen E, Sung R J, Gonzales R, Scheinman M M
Am J Cardiol. 1983 Jun;51(10):1623-8. doi: 10.1016/0002-9149(83)90198-4.
Twenty patients with the Wolff-Parkinson-White (WPW) syndrome and 1 or more episodes of symptomatic atrial fibrillation (AF) due to rapid anterograde bypass tract conduction underwent electrophysiologic testing. The mean ventricular rate during spontaneous AF was 242 +/- 56 beats/min (+/- standard deviation) and the shortest preexcited R-R interval was 194 +/- 40 ms. Six patients underwent surgical bypass tract ablation and 14 were treated medically, based on the results of electropharmacologic testing. Over a mean follow-up period of 35 +/- 19 months (+/- standard deviation), only 1 patient treated medically had a recurrence of minimally symptomatic AF. The successful chemoprophylaxis of symptomatic AF was associated with the inability to induce AF and atrioventricular reciprocating tachycardia during drug testing (7 patients) or with the induction of AF with a ventricular rate less than 200 beats/min and a shortest preexcited R-R interval of greater than 250 ms (7 patients). Electrophysiologic testing can identify a subgroup of patients with WPW and AF in whom medical therapy is a suitable alternative to bypass tract ablation.
20例患有预激综合征（WPW）且因旁路前传快速传导而出现1次或更多次症状性房颤（AF）发作的患者接受了电生理检查。自发房颤期间的平均心室率为242±56次/分钟（±标准差），最短预激R-R间期为194±40毫秒。根据电药理检查结果，6例患者接受了手术旁路消融，14例接受了药物治疗。在平均35±19个月（±标准差）的随访期内，仅1例接受药物治疗的患者出现了轻微症状性房颤复发。症状性房颤的成功化学预防与药物测试期间无法诱发房颤和房室折返性心动过速（7例患者）或诱发心室率低于200次/分钟且最短预激R-R间期大于250毫秒的房颤有关（7例患者）。电生理检查可以识别出预激综合征合并房颤患者中的一个亚组，对于他们来说，药物治疗是替代旁路消融的合适选择。
