Korean Circ J.  1979 Jun;9(1):27-45. 10.4070/kcj.1979.9.1.27.

Wolff-Parkinson-White Syndrome and Pre-excitation Dysrrhythmia

Abstract

Since its initial description in 1930, the preexcitation or Wolff-Parkinson-White(W-P-W) syndrome is characterized by a special electrocardiographic pattern and various paroxysmal tachyarrhythmia, which was found to have reciprocating tachycardia frequently. The W-P-W syndrome develops when some part of a ventricle is activated earlier than normal conduction pathway, and described as one type of ventricular preexcitation syndromes by Durrer (1974). The diagnostic criteria of the W-P-W syndrome are 1) initial slurring (delta wave) of the QRS complex, 2) short P-R interval, 3) widened QRS complex and 4) secondary T wave change. The initial slurring of the QRS complex (delta wave) which is the most important finding of preexcitation syndrome results from a premature activation of a portion of the ventricle through an accessary pathway which bypasses the A-V node and bundle. These accessary conduction fiber includes Kent's bundle, Jame's fibers, Mahaim's fibers and its combination. Recent developments in the field of electrophysiology and surgical therapy became to support the concept of anomalous pathways and the possible determination of the re-entry circuit of paroxysmal tachycardia. Total 12 cases including 9 cases of classical W-P-W syndromes and 3 cases of L-G-L syndromes were followed with special interest of pre-excitation phenomenon and paroxysmal tachyarrhythmia at the National medical Center during the period of Jan. 1975 to Feb. 1979 and found to have paroxysmal tachyarrhythmia in 8 cases out of 12 cases. His bundle electrogram (HBE) and right atrial pacing were recoded in 2 cases of W-P-W type B to support the existance of an anomalous pathway. Treatment was instituted in accordance with recent advanced knowledge for the paroxysmal tachyarrhymia and pre-excitation and references were reviewed.


MeSH Terms

Atrioventricular Node
Electrocardiography
Electrophysiologic Techniques, Cardiac
Electrophysiology
Pre-Excitation Syndromes
Tachycardia
Tachycardia, Paroxysmal
Tachycardia, Reciprocating
Wolff-Parkinson-White Syndrome*
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