If your institution subscribes to this resource, and you don't have a MyAccess Profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus. Ventricular preexcitation syndrome. Occurrence of frequent paroxysms of tachycardia in patients with short PR interval was described by A. Clerc in , but B. Lown, W.
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Ventricular preexcitation syndrome. Occurrence of frequent paroxysms of tachycardia in patients with short PR interval was described by A. Clerc in , but B. Lown, W. Ganong, and S. Levine gave it their eponym in Ventricular preexcitation syndrome other types include Wolff-Parkinson-White syndrome via Kent fibers and preexcitation via Mahaim fibers. Retrospective analysis has suggested that paroxysmal supraventricular tachycardia occurs in approximately 9. A familial occurrence has been suggested.
These tracts insert into the bundle of His or its branches; thus, the ventricles are depolarized in a normal sequence and the QRS complex appears normal on ECG no delta wave as in Wolff-Parkinson-White syndrome. Paroxysmal tachycardias classically arise from reentry through the bypass tract. Direct atrioventricular connections have been suggested to be part of the syndrome; such connections could allow tachycardias to develop as a result of antegrade, rather than retrograde, conduction.
Patients may remain asymptomatic. Episodes of paroxysmal palpitation atrial flutter, supraventricular tachycardia may be associated with shortness of breath, signs of ventricular failure, and syncope. Investigations include ECG and electrophysiologic studies to define the site of accessory conducting tissue and the individual mechanism for tachycardia generation. The tachycardia is usually a narrow complex, but functional right bundle or left bundle branch block may cause a wide complex tachycardia.
Several drugs may be used in the management of the condition, including adenosine acutely , verapamil, beta blocker, procainamide, amiodarone, or digitalis. However, verapamil and digoxin are contraindicated for treatment of atrial fibrillation or flutter in these patients because they might accelerate conduction through the bypass tract and induce ventricular fibrillation.
Surgical or catheter pathway ablation or pacemakers overdrive pacing may be used. Obtain a history of the frequency of dysrhythmias and the current treatment regimen. Continue antidysrhythmic drugs perioperatively. In case of chronic amiodarone therapy, check thyroid function and exclude pulmonary fibrosis. Review the results of electrophysiologic studies if available. Preoperative ECG mandatory. Data regarding pacemaker if overdrive pacing is being used to control supraventricular tachycardias.
Correct any electrolyte disturbance sodium, potassium, and magnesium. Minimize perioperative catecholamine surges. Premedication may be beneficial. Atropine is relatively contraindicated.
Hypoxia, hypercarbia, or acidosis must be prevented because all these complications render cardiac muscle membranes unstable and ectopic depolarization more likely. Same as for Wolff-Parkinson-White syndrome.
Enflurane is the volatile agent that probably is least likely to induce arrhythmia. Halothane is contraindicated proarrhythmogenic, myocardial depressant.
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Only comments seeking to improve the quality and accuracy of information on the Orphanet website are accepted. For all other comments, please send your remarks via contact us. Only comments written in English can be processed. Lown-Ganong-Levine syndrome is an extremely rare conduction disorder characterized by a short PR interval less than or equal to ms with normal QRS complex on electrocardiogram associated with the occurrence of episodes of atrial tachyarrythmias e. Other search option s Alphabetical list. Suggest an update.
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