How to treat preexcitation syndrome?

The occurrence of preexcitation syndrome is that in addition to some normal conduction pathways between the atrioventricular and ventricular parts of the heart, there is also a short-circuit conduction phenomenon, which leads to accelerated conduction between the atrioventricular and ventricular parts, causing people to have pre-excitation of the ventricular muscle. This situation is also called abnormal or accelerated atrioventricular conduction. Therefore, it is also the prerequisite for the occurrence of preexcitation syndrome. Let us understand together how to treat preexcitation syndrome.

After preexcitation syndrome occurs, one must actively learn more about the symptoms of one's own disease, knowing that simple preexcitation does not have any symptoms. Moreover, supraventricular tachycardia is very similar to common supraventricular tachycardia in clinical practice. For patients with atrial flutter or atrial fibrillation, the ventricular rate is mostly around 200 beats/min. In addition to discomfort such as palpitations, shock, heart failure and even sudden death may occur. When the ventricular rate is extremely fast, such as 300 beats/min, the heart sounds detected by auscultation may be only half of the ventricular rate on the electrocardiogram, indicating that half of the ventricular excitation cannot produce effective mechanical contraction.

Preexcitation itself does not require specific treatment. When concurrent supraventricular tachycardia occurs, the treatment is the same as general supraventricular tachycardia. When atrial fibrillation or atrial flutter occurs, if the ventricular rate is fast and accompanied by circulatory disorders, synchronized direct current cardioversion should be used as soon as possible. Lidocaine, procainamide, propafenone, and amiodarone slow conduction along the accessory pathway, which can slow the ventricular rate or convert atrial fibrillation and flutter to sinus rhythm. Digitalis accelerates conduction along the accessory pathway, while verapamil and propranolol slow down conduction within the atrioventricular node, both of which may significantly increase the ventricular rate or even develop into ventricular fibrillation, so they should not be used.

If supraventricular tachycardia, atrial fibrillation or atrial flutter occurs frequently, it is advisable to take the above-mentioned antiarrhythmic drugs orally for a long time to prevent attacks. For patients who cannot be controlled by drugs, whose electrophysiological examination confirms that the refractory period of the bypass pathway is short or is shortened during rapid atrial pacing, or whose ventricular rate reaches about 200 beats/min during atrial fibrillation, there are indications for electrical, radiofrequency, laser or cryoablation after positioning, or surgical severance of the bypass pathway to prevent attacks.

Preexcitation syndrome is a stubborn disease that is very difficult to treat. The high incidence of this disease will cause the preexcitation syndrome to become serious. Therefore, in the following, we must recognize the types and symptoms of preexcitation syndrome and actively cooperate with the treatment to ensure that preexcitation syndrome is treated and cured in time.