Sealy W C
Am J Surg. 1983 Jun;145(6):756-62. doi: 10.1016/0002-9610(83)90134-4.
In this report, the surgical experience with the treatment of Wolff-Parkinson-White syndrome in 190 patients who had 210 Kent bundles has been summarized. The patients with reentry tachycardia caused by the Kent bundle were relieved by Kent division or by His division, the latter being used only in 10 percent of the patients. A malignant ventricular arrhythmia was found in 25 percent of the patients and was due to a Kent bundle that conducted an atrial flutter-fibrillation 1:1 to the ventricle. This arrhythmia was corrected by Kent interruption, since the Kent bundle alone participated in the arrhythmia. Other unusual manifestations of Kent bundles were found, such as multiple pathways, unidirectional conducting pathways, and pathways causing incessant junctional tachycardia. Other cardiac problems were frequently present, such as hypertrophic cardiomyopathy and Ebstein's anomaly. Even in such a multifaceted problem caused by a minute congenital abnormality, careful application of sophisticated electrophysiologic measurements followed by appropriate surgical methods have proved to be effective in correcting the two arrhythmias associated with Wolff-Parkinson-White syndrome.
在本报告中，总结了对190例存在210条肯特束的预激综合征患者的手术治疗经验。由肯特束引起的折返性心动过速患者，通过切断肯特束或希氏束得到缓解，后者仅用于10%的患者。25%的患者发现有恶性室性心律失常，其原因是一条肯特束将心房扑动-颤动以1:1的比例传导至心室。由于仅肯特束参与心律失常，通过切断肯特束纠正了这种心律失常。还发现了肯特束的其他异常表现，如多条径路、单向传导径路以及导致无休止性交界性心动过速的径路。还经常存在其他心脏问题，如肥厚型心肌病和埃布斯坦畸形。即使是由微小先天性异常引起的如此多方面的问题，通过仔细应用复杂的电生理测量方法，随后采用适当的手术方法，已证明对纠正与预激综合征相关的两种心律失常是有效的。
