Pre-excitation Syndromes
The classification of pre-excitation syndromes has evolved since the original eponyms were given to Kent, Mahaim, and James fibers - Samuel Levy
image by: HWN
HWN Suggests
Pre-excitation syndromes
Pre-excitation refers to early activation of the ventricles due to impulses bypassing the AV node via an AP. Also known as bypass tracts, APs are abnormal conduction pathways formed during cardiac development and can exist in a variety of anatomical locations and in some patients there may be multiple pathways. In WPW, the AP is sometimes referred to as the Bundle of Kent, or atrioventricular bypass tract.
Featured
Preexcitation Syndromes
Preexcitation occurs when the ventricles are activated by an impulse from the atria sooner than would be expected if the impulse were transmitted down the normal conducting pathway (the AV node). Several different forms of preexcitation have been described, based on anatomic, clinical, electrocardiographic, and electrophysiologic abnormalities.
Articles of Interest
Myth: Intravenous amiodarone is safe in patients with atrial fibrillation and Wolff–Parkinson–White syndrome in the emergency department
The lack of evidence showing safety and efficacy, and the presence of several case reports and case series suggesting possible harm strongly suggest that amiodarone is not a preferred treatment for AF–WPW, contrary to ACLS guidelines. As the only therapeutic modality lacking proarrhythmic properties, DC cardioversion is likely the fastest and safest option.
Pre-excitation syndromes: Wolff-Parkinson-White, etc.
Videos...
Resources
4 Preexcitation Syndromes
Preexcitation due to an AV accessory pathway is a variable fusion between ventricular excitation over the accessory pathway and the normal conduction system.
ScienceDirect
The classification of pre-excitation syndromes has evolved since the original eponyms were given to Kent, Mahaim, and James fibers.
