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Pre-excitation syndrome is a heart condition in which part of the cardiac ventricles are activated too early. [1] Pre-excitation is caused by an abnormal electrical connection or accessory pathway between or within the cardiac chambers. Pre-excitation may not cause any symptoms but may lead to palpitations caused by abnormal heart rhythms.
Lown–Ganong–Levine syndrome (LGL) is a pre-excitation syndrome of the heart. Those with LGL syndrome have episodes of abnormal heart racing with a short PR interval and normal QRS complexes seen on their electrocardiogram when in a normal sinus rhythm.
Atrial fibrillation is associated with an increased risk of heart failure, dementia, and stroke. [3] [12] It is a type of supraventricular tachycardia. [14] Atrial fibrillation frequently results from bursts of tachycardia that originate in muscle bundles extending from the atrium to the pulmonary veins. [15]
If atrial fibrillation with pre-excitation occurs, treatment options include procainamide, flecainide, propafenone, dofetilide, and ibutilide, since these medications slow conduction in the accessory pathway causing the tachycardia and should be administered before considering electrical cardioversion.
WPW carries a small risk of sudden death, presumably due to rapidly conducted atrial fibrillation causing ventricular fibrillation. While the overall risk is approximately 2.4 per 1000 person years, the risk in an individual is dependent on the properties of the accessory pathway causing pre-excitation. [8]
Pre-excitation refers to early activation of the ventricles due to impulses bypassing the AV node via an accessory pathway. [10] Accessory pathways are abnormal conduction pathways formed during cardiac development. An example of pre-excitation syndromes is Wolff Parkinson White syndrome. Here, the presence of a left lateral accessory pathway ...