INTERMITTENT PREEXCITATION IN THE WOLFF-PARKINSON-WHITE SYNDROME
INTERMITTENT PREEXCITATION IN THE WOLFF-PARKINSON-WHITE SYNDROME
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DOI：
10.1016/0002-9149(83)90125-x
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发表时间：
1983-01-01
影响因子：
2.8
通讯作者：
GULAMHUSEIN, SS
中科院分区：
文献类型：
--
作者：
KLEIN, GJ;GULAMHUSEIN, SS
Wolff-Parkinson-White(WPW)综合征的间歇性Delta波丢失可能是由于旁路传导不稳定所致，因此，在发生心房颤动(AF)的情况下，可能预示着良性预后。对52名连续入选的WPW综合征患者进行评估，并通过回顾连续心电图、动态监测和跑台试验来确定间歇性预激的发生率。所有患者随后都接受了使用标准技术的电生理测试，以确定旁路的特性。在52例患者中，26例(50%)被发现有间歇性兴奋，其定义为至少1次三角洲波丢失并伴随P-R间期延长。这些患者有较长的旁路有效不应期(356.+-)。114比295。+-。29毫秒，平均+-。SD，P<；0.05)和更长的最短周期长度保持1：1顺行传导(426。+-)。176对291。+-。63ms，P<；0.02)。在房颤期间，15%的间歇性预激患者的预激搏动与250ms之间的R-R间期最短，而持续预激的患者中这一比例为50%(P<；0.01)。显然，间歇性预激提示房颤的预后良好。仔细搜索间歇性预激可能会在无症状的受试者中产生重要的预后信息，并排除进一步的研究。
Intermittent loss of the delta wave in the Wolff-Parkinson-White (WPW) syndrome may result from precarious conduction over the accessory pathway and, as such, would predict a benign prognosis in the event of the occurrence of atrial fibrillation (AF). Consecutive patients (52) referred for the assessment of the WPW syndrome were evaluated and the prevalence of intermittent preexcitation using review of serial ECG, ambulatory monitoring and treadmill testing was determined. All patients subsequently had electrophysiologic testing using standard techniques to determine the properties of the accessory pathway. Of the 52 patients, 26 (50%) were found to have intermittent prexcitation as defined by loss of the delta wave with concomitant prolongation of the P-R interval on at least 1 occasion. These patients had longer effective refractory periods of the accessory pathway (356 .+-. 114 vs. 295 .+-. 29 ms, mean .+-. SD, P < 0.05) and longer shortest cycle lengths maintaining 1:1 anterograde conduction (426 .+-. 176 vs. 291 .+-. 63 ms, P < 0.02) than their counterparts with constant preexcitation. During AF, 15% of patients with intermittent preexcitation had shortest R-R intervals between preexcited beats < 250 ms, vs. 50% of patients with constant preexcitation (P < 0.01). Apparently, intermittent preexcitation suggests a benign prognosis in the event of AF. A careful search for intermittent preexcitation may yield important prognostic information in asymptomatic subjects and obviate further investigation.