Pre-Excitation Syndromes (Pre-Excitation Syndrome)

A group of conditions in which HEART VENTRICLE activation by the atrial impulse is faster than the normal impulse conduction from the SINOATRIAL NODE. In these pre-excitation syndromes, atrial impulses often bypass the ATRIOVENTRICULAR NODE delay and travel via ACCESSORY CONDUCTING PATHWAYS connecting the atrium directly to the BUNDLE OF HIS.

Also Known As:

Networked: 117 relevant articles (7 outcomes, 7 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Ventricular Tachycardia
2.	Tachycardia (Tachyarrhythmias)
3.	Atrial Fibrillation
4.	Supraventricular Tachycardia
5.	Wolff-Parkinson-White Syndrome (Wolf-Parkinson-White Syndrome)

Experts

1.	Balsam, Paweł: 2 articles (01/2022 - 01/2022)
2.	Grabowski, Marcin: 2 articles (01/2022 - 01/2022)
3.	Lodziński, Piotr: 2 articles (01/2022 - 01/2022)
4.	Pietrzak, Radosław: 2 articles (01/2022 - 01/2022)
5.	Werner, Bożena: 2 articles (01/2022 - 01/2022)
6.	Liu, Renguang: 2 articles (03/2017 - 04/2013)
7.	Brembilla-Perrot, B: 2 articles (07/2013 - 08/2010)
8.	Trappe, Hans-Joachim: 2 articles (04/2010 - 10/2003)
9.	Kalarus, Z: 2 articles (08/2001 - 07/2001)
10.	Kowalski, O: 2 articles (08/2001 - 07/2001)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Pre-Excitation Syndromes:

1.	Amiodarone (Amiodarona)FDA LinkGeneric 09/01/1987 - "Amiodarone treatment in cardiac preexcitation syndrome: use of signal averaged electrocardiogram." 01/01/1994 - "[Role of cordarone in the treatment of paroxysmal supraventricular tachyarrhythmia in pre-excitation syndrome]." 05/01/1984 - "Electrophysiologic basis for the suppression by amiodarone of orthodromic supraventricular tachycardias complicating pre-excitation syndromes." 06/15/1977 - "[Amiodarone hydrochloride in the treatment of arrhythmia in pre-excitation syndromes]." 08/01/1987 - "We report a case of cardiac pre-excitation syndrome in a young male patient in whom amiodarone therapy (3000 mg/weekly) was instituted to modify the dangerous ventricular response during atrial fibrillation (shortest R-R interval 190 ms, ventricular rate 210 beats/min). "
2.	Flecainide (Tambocor)FDA LinkGeneric 10/01/1985 - "Flecainide appears one of the best choices for the treatment of preexcitation syndromes and their related arrhythmias at the present time." 01/01/1986 - "Flecainide is highly effective in the treatment of ventricular arrhythmias, pre-excitation syndromes and AV reentry tachycardias. " 08/25/1988 - "Treatment of atrial tachyarrhythmias and preexcitation syndrome with flecainide acetate." 07/15/1989 - "To determine the reversibility of the effects of flecainide on accessory pathways, electrophysiologic studies were performed in the drug-free control state, after flecainide loading and with isoproterenol infusion during flecainide treatment in 12 patients with symptomatic preexcitation syndrome. " 10/01/2004 - "The drug of choice for atrial fibrillation in pre-excitation syndrome is procainamide but propafenone, flecainide and disopyramide have also been used. "
3.	Anti-Arrhythmia AgentsIBA 02/01/1992 - "A comparative study of antiarrhythmic drugs was performed in 81 patients with atrial fibrillation attacks in the presence of preexcitation syndrome. " 01/01/1992 - "Evolution of the effectiveness of antiarrhythmic drugs used in 240 patients with preexcitation syndrome to arrest episodes of paroxysmal supraventricular tachycardia was analysed prospectively. " 09/15/1994 - "The indications for ablation include preexcitation syndromes, atrioventricular nodal reentrant tachycardia, and other selected atrial and ventricular tachyarrhythmias refractory to antiarrhythmic drug therapy. " 06/01/1992 - "Proarrhythmic effects may be observed at atrial (vagal or sympathetic arrhythmias, 1/1 flutter, acceleration of atrial fibrillation in preexcitation syndromes), junctional (artificial unidirectional block created by the antiarrhythmic drug which may be very effective at higher dosages: biphasic effect) or ventricular (aggravation of ventricular extrasystoles, torsades de pointe, ventricular tachycardia/fibrillation) levels. " 04/01/1987 - "consecutive sample of 36 patients with atrial fibrillation of 7 days' duration or less, not on digitalis glycoside or anti-arrhythmic agents, with ventricular rate between 85 to 175 beats/min, without evidence of heart failure, acute myocardial infarction, unstable angina, preexcitation syndrome, thyrotoxicosis, hypokalemia, renal impairment, or severe metabolic disturbances. "
4.	Moricizine (Moracizine)FDA Link 09/01/1984 - "Thus intravenous ethmozin terminated induced SVT and prevented the induction of sustained SVT in most patients with preexcitation syndrome due to a suppressive effect of the drug on AP." 10/16/1987 - "Oral moricizine HCl (600 to 800 mg/24 hours) prevented tachycardia in 40% of patients with a preexcitation syndrome. " 09/01/1984 - "Electrophysiologic effects of intravenous ethmozin (1.5 to 2 mg/kg) were evaluated in 16 patients (10 with Wolff-Parkinson-White [WPW] syndrome and six with concealed accessory pathway [AP]) with ventricular preexcitation syndrome. " 11/01/1986 - "Ritmilen proved particularly effective in patients with paroxysmal tachycardias in the presence of the ventricular pre-excitation syndrome, while cordarone and etmozin were most effective antiarrhythmic drugs for reciprocal ventricular tachycardias. "
5.	Disopyramide (Norpace)FDA LinkGeneric 10/01/2004 - "The drug of choice for atrial fibrillation in pre-excitation syndrome is procainamide but propafenone, flecainide and disopyramide have also been used. " 11/01/1986 - "Ritmilen proved particularly effective in patients with paroxysmal tachycardias in the presence of the ventricular pre-excitation syndrome, while cordarone and etmozin were most effective antiarrhythmic drugs for reciprocal ventricular tachycardias. "
6.	Isoproterenol (Isoprenaline)FDA LinkGeneric 06/01/2013 - "Electrophysiological study was performed in 807 patients with a pre-excitation syndrome in control state and after isoproterenol. " 08/01/2010 - "Isoproterenol infusion is required in the preexcitation syndrome to look for the shortening of accessory refractory period. " 07/15/1989 - "To determine the reversibility of the effects of flecainide on accessory pathways, electrophysiologic studies were performed in the drug-free control state, after flecainide loading and with isoproterenol infusion during flecainide treatment in 12 patients with symptomatic preexcitation syndrome. " 11/01/1992 - "Electrophysiological and electropharmacological studies in pre-excitation syndromes: results with propafenone therapy and isoproterenol infusion testing."
7.	Propafenone (Rythmol)FDA LinkGeneric 11/01/1992 - "To study the electrophysiological effects of oral propafenone on accessory pathways and determine the potential for catecholamine-mediated reversal of these effects, comprehensive electrophysiology studies (EPS) were conducted in 11 patients with manifest (n = 9) or concealed (n = 2) pre-excitation syndrome. " 11/01/1992 - "Electrophysiological and electropharmacological studies in pre-excitation syndromes: results with propafenone therapy and isoproterenol infusion testing." 10/01/2004 - "The drug of choice for atrial fibrillation in pre-excitation syndrome is procainamide but propafenone, flecainide and disopyramide have also been used. "
8.	CatecholaminesIBA 11/01/1992 - "To study the electrophysiological effects of oral propafenone on accessory pathways and determine the potential for catecholamine-mediated reversal of these effects, comprehensive electrophysiology studies (EPS) were conducted in 11 patients with manifest (n = 9) or concealed (n = 2) pre-excitation syndrome. "
9.	Verapamil (Calan)FDA LinkGeneric 06/01/1978 - "Evaluation of verapamil in the management of pre-excitation syndrome." 01/01/1976 - "Effects of verapamil (5 mg i.v.) on excitation conduction in 20 patients who already had a basic alteration (7 with ventricular pre-excitation syndrome) were studied by His electrogram, during spontaneous sinusal rhythm and atrial electrostimulation in increasing frequencies. " 01/01/1975 - "[Demonstration of a major preexcitation syndrome during treatment of auricular flutter using intravenous injection of verapamil]." 11/01/2009 - "Hemodynamically stable patients with atrial fibrillation or atrial flutter, a rapid ventricular rate and without preexcitation syndrome should be treated with intravenous beta-adrenergic blocking drugs, amiodarone, verapamil, or diltiazem. "
10.	Adenosine (Adenocard)FDA LinkGeneric 04/01/2011 - "Use of adenosine test for the exclusion of preexcitation syndrome in asymptomatic individuals." 05/01/2001 - "[Adenosine in the preexcitation syndrome]." 05/01/2008 - "Nonsustained polymorphic ventricular tachycardia during adenosine stress perfusion imaging in the setting of resting pre-excitation electrocardiographic pattern: should we be avoiding adenosine pharmacologic stress testing in pre-excitation syndromes?" 06/01/2002 - "Valsalva maneuver and adenosine are effective therapies for many patients with PSVT, although any conversion to an irregular or wide complex tachycardia should prompt consideration of a preexcitation syndrome. "

Therapies and Procedures

1.	Catheter Ablation 11/17/2023 - "Seven consecutive cases of pre-excitation syndromes with prior failed RF catheter ablation had the novel treatment. " 10/01/1996 - "Twelve patients (mean age 36 +/- 17 years) with variants of the preexcitation syndromes underwent electrophysiologic study and radiofrequency catheter ablation. " 01/01/2022 - "Assessment of the physical performance in children with preexcitation syndrome, before and after catheter ablation of the accessory pathway: A pilot study." 01/01/2022 - "Success rate and safety of catheter ablation in preexcitation syndrome: A comparison between adult and pediatric patients." 02/01/2016 - "Assessment of Left Atrial Mechanics in Patients with Preexcitation Syndrome Scheduled for Catheter Ablation."
2.	Therapeutics 01/01/2005 - "Despite these early studies supporting the bypass theory, the quest for alternative mechanisms continued until the 1970s when electrophysiological studies and surgical therapy confirmed accessory connections as the mechanism of pre-excitation syndrome." 01/01/1978 - "Current methodology permits one to define the functional basis of the preexcitation syndromes with reasonable certainty and to develop a rationale for instituting trials of medical therapy. " 03/01/2013 - "Left ventricular dyssynchrony in pre-excitation syndrome: effect of accessory pathway location and reversibility after ablation therapy." 09/01/1989 - "Preexcitation syndromes: surgical ablation therapy. " 02/01/1983 - "Transesophageal pacing for prognostic evaluation of preexcitation syndrome and assessment of protective therapy."
3.	Radiofrequency Ablation 01/01/2023 - "Two-dimensional speckle tracking imaging to assess the hazards of left ventricular function and ventricular wall motion disorders in children with pre-excitation syndrome and the efficacy of radiofrequency ablation treatment." 03/01/2017 - "Note that 150 patients had delta wave (overt AP group) on ECG; classical preexcitation syndrome was diagnosed before radiofrequency ablation. " 04/16/1993 - "[Radiofrequency ablation of accessory pathways in pre-excitation syndrome]." 06/01/1992 - "Current status of radiofrequency ablation in the preexcitation syndromes." 09/01/2006 - "Radiofrequency ablation (RFA) of accessory pathways (AP) is the first line therapy in symptomatic patients with preexcitation syndrome, resistant to medical therapy. "
4.	Catheters 06/01/1976 - "Bipolar catheter electrograms for study of retrograde atrial activation pattern in patients without pre-excitation syndromes." 01/01/1995 - "Recently, endocardial catheter mapping and radiofrequency catheter ablation have substantially contributed to the characterization of this unusual form of the preexcitation syndrome. " 11/01/1978 - "Catheter-induced conduction delay or block in the accessory atrioventricular pathway of four patients with the preexcitation syndrome was observed. "
5.	Drug Therapy (Chemotherapy) 05/01/1994 - "These standard pharmacotherapies however, are contraindicated in ventricular preexcitation syndrome associated with rapid ventricular rate due to AF. " 08/01/1977 - "[Drug therapy of pre-excitation syndromes]." 06/01/2007 - "Because of the potential disadvantages of a life-long drug therapy and relatively favourable results from radiofrequency catheter ablation (RFCA) therapy in adults, the indications for ablation therapy in children with preexcitation syndrome (PS) need to be considered. "