Probst P, Ebm W, Weber H, Pachinger O, Klicpera M
Z Kardiol. 1982 Jun;71(6):421-6.
In 65 out of 79 patients with WPW syndrome who had extensive electrostimulation studies, a follow-up evaluation (mean follow-up period 2.5 years) was performed. The patients were divided into 2 groups: Group 1: No therapy or therapy only during tachycardia. Group 2: Continuous oral drug therapy. There was no difference of antegrade and retrograde refractory periods, but there was a significant difference in the initiation of tachycardias. In group 1, the typical reentry tachycardia using the AV node antegradely and the accessory pathway retrogradely was predominant, while in group 2, complex arrhythmias (atrial fibrillation + reentry tachycardia, tachycardias using the accessory pathway in both directions, reentry tachycardia + AV-nodal tachycardia, isolated atrial fibrillation) during electrostimulation could be induced. all except 1 patient in whom no tachycardia could be initiated were in group 1 (statistically significant difference). Thus the type of tachycardia which can be initiated during electrostimulation is a better predictor for the condition in the follow-up period than the refractory period. As concomitant disease there were 4 cases with Ebstein disease (2 had additional mitral valve prolapse syndrome) and 3 cases with mitral valve prolapse syndrome. 3 of the 4 patients with Ebstein disease were in group 2. 1 of the 64 patients died during the follow-up period suddenly, but the cause of death is not known and possibly due to medical therapy. The mortality in a non-selected group of patients with WPW syndrome seems to be very low.
在79例接受广泛电刺激研究的预激综合征患者中,对65例进行了随访评估(平均随访期2.5年)。患者被分为两组:第1组:不进行治疗或仅在心动过速发作时治疗。第2组:持续口服药物治疗。顺行和逆行不应期无差异,但心动过速的诱发情况有显著差异。在第1组中,以经房室结顺行、经旁路逆行的典型折返性心动过速为主,而在第2组中,电刺激时可诱发复杂心律失常(心房颤动 + 折返性心动过速、双向经旁路的心动过速、折返性心动过速 + 房室结性心动过速、孤立性心房颤动)。除1例未诱发心动过速的患者外,其余均在第1组(差异有统计学意义)。因此,电刺激时可诱发的心动过速类型比不应期更能预测随访期的病情。合并疾病方面,有4例埃布斯坦综合征患者(2例合并二尖瓣脱垂综合征)和3例二尖瓣脱垂综合征患者。4例埃布斯坦综合征患者中有3例在第2组。64例患者中有1例在随访期间突然死亡,但死因不明,可能与药物治疗有关。预激综合征非选择性患者组的死亡率似乎很低。