Treatment of Patients With Ventricular Preexcitation
| Autor: | Esteban González Torrecilla, Jesús Almendral Garrote, Felipe Atienza Fernández, Ángel Arenal Maíz, Dolores Vigil Escribano |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Tachycardia
medicine.medical_specialty medicine.medical_treatment Population Catheter ablation Accessory pathway Asymptomatic Sudden death Electrocardiography Internal medicine medicine Humans education Clinical Trials as Topic education.field_of_study medicine.diagnostic_test business.industry General Medicine Procainamide Anesthesia Catheter Ablation Tachycardia Ventricular Cardiology medicine.symptom business Anti-Arrhythmia Agents medicine.drug |
| Zdroj: | Europe PubMed Central |
| ISSN: | 1885-5857 |
| Popis: | Ventricular preexcitation, due to an accessory pathway that creates an electrical connection between the atria with the ventricles, can provide a substrate for a variety of arrhythmogenic syndromes, from paroxysmal AV junctional tachycardia, to the facilitation or aggravation of atrial tachyarrhythmias that can lead to sudden death. However, statistics show that the most frequent situation is for the individual to remain asymptomatic throughout his or her life. In the asymptomatic individual, population-based studies with very long follow-up periods indicate that the risk of sudden death is minimal. Acute therapy for tachyarrhythmias is based on adenosine/verapamil for regular, narrow-QRS tachycardias and procainamide/electrical cardioversion for preexcited tachyarrhythmias. Chronic pharmacologic therapy with antiarrhythmic drugs is not recommended because its efficacy is not well proven and its risk of side effects can be considerable. In symptomatic patients, the treatment of choice is catheter ablation, with an efficacy of 93%, a complication rate of 1% and a mortality rate of 1 per thousand. Whether catheter ablation should be recommended for asymptomatic individuals remains controversial. The authors recommend that these individuals should be followed with regular clinical evaluation, and that catheter ablation should be advised only for those who become symptomatic. |
| Databáze: | OpenAIRE |
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