Kappenberger L, Gloor H O, Steinbrunn W
Schweiz Med Wochenschr. 1980 Nov 8;110(45):1672-4.
In 13 patients with Wolff-Parkinson-White syndrome (WPW) the findings from electrophysiologic studies have been correlated with the patients' histories. Four patients had had syncopes with tachycardia and at least one episode of cardiac resuscitation (group 1). Five patients with tachycardias had never had syncope (group 2). Group 1 and group 2 had anterograde conduction over an accessory atrio-ventricular pathway (AAVP) during investigation, while 4 patients had concealed pathways (group 3). Age, localization of AAVP, duration of tachycardia history and heart rate during regular tachycardia did not differ in the three groups. Atrial and anterograde effective refractory period of AAVP was shorter in group 1 (280 +/- 10 msec) than in group 2 (328 +/- 15 msec). Shortest RR-interval during atrial fibrillation was 230 +/- 30 msec in group 1 versus 295 +/- 10 msec in group 2. It is concluded that potentially dangerous tachyarrhythmias are due to short refractory period of AAVV. Patients with syncope and WPW-syndrome should undergo electrophysiologic investigation and be selected for controlled antiarrhythmic treatment or surgical dissection of AAVP.
在13例预激综合征（WPW）患者中，电生理研究结果与患者病史相关。4例患者有心动过速伴晕厥且至少有一次心脏复苏经历（第1组）。5例有心动过速的患者从未发生过晕厥（第2组）。第1组和第2组在检查期间经附加房室旁路（AAVP）有前传，而4例患者有隐匿性旁路（第3组）。三组患者的年龄、AAVP定位、心动过速病史时长及规则心动过速时的心率无差异。第1组AAVP的心房和前传有效不应期（280±10毫秒）短于第2组（328±15毫秒）。第1组房颤时最短RR间期为230±30毫秒，而第2组为295±10毫秒。结论是潜在危险的快速心律失常归因于AAVV不应期短。有晕厥和WPW综合征的患者应接受电生理检查，并选择进行抗心律失常控制治疗或AAVP手术切断。
