RESUMO
Cases of familial preexcitation syndrome represent a specific subgroup of patients that may result from diverse mechanisms: failure in development and genetic predisposition are the main mechanism involved. We determined the prevalence of this syndrome in first degree relatives of patients with proved accessory pathways by electrophysiologic study and compared such prevalence with the general population (0.15%). In five out of 469 patients (1.06%) we found an accessory pathway in one or more member of their family. Only 6 out of 3752 had preexcitation (0.15%); this prevalence was similar to the general population (P = NS). The identification of family members with this syndrome may be incomplete because we only chose for the study symptomatic patients. We did not observed multiple pathways and in one case we found atrial septal defect. Our data demonstrated familial preexcitation in five families suggesting hereditary predisposition.
Assuntos
Nó Atrioventricular/anormalidades , Síndromes de Pré-Excitação/epidemiologia , Síndromes de Pré-Excitação/genética , Adolescente , Adulto , Análise de Variância , Criança , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Feminino , Humanos , Incidência , Masculino , México/epidemiologia , Linhagem , Prevalência , Fatores de RiscoRESUMO
Los casos de preexcitación familiar representan un subgrupo específico de personas en quienes la preexcitación resulta de más de un mecanismo etiológico; errores en el desarrollo y una predisposición genética son los principales mecanismos involucrados. Se determinó la prevalencia de preexcitación en los familiares en primer grado de 469 pacientes consecutivos con síndrome de Wolff-Parkinson-White comprobado electrofisiológicamente. Comparamos la prevalencia de preexcitación de los 3752 familiares en primer grado con la frecuencia observada en la población general (0.15 por ciento). En cinco pacientes con síndrome de Wolff-Parkinson-White (1.06 por ciento), se documentó una vía accesoria en uno o más de sus familiares en primer grado. Sólo 6 de los 3752 familiares en primer grado presentaron preexcitación (0.15); esta prevalencia fue similar a la reportada en la población general (P = NS). La identificación de familiares en primer grado puede ser incompleta debido a que sólo se tomaron para el estudio a familiares de pacientes sintomáticos con síndrome de Wolff-Parkinson-Whitte. No se observó la presencia de vías accesorias múltiples y en un solo caso se verificó la existencia de una comunicación interauricular
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Análise de Variância , Nó Atrioventricular/anormalidades , Síndromes de Pré-Excitação/epidemiologia , Síndromes de Pré-Excitação/genética , Incidência , México/epidemiologia , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Prevalência , Fatores de RiscoRESUMO
Se revisaron 10,000 electrocardiogramas de la región de Azuero econtrándose 0,8% de preexcitaciones. La frecuencia de Wolff-Parkinson-White fue de 0,15% mientras que la Lown-Ganong-Levine fue de 0,65%. En los casos de Wolff-Parkinson-White hubo predominio de varones y mayor número de casos del tipo B sin que la diferencia fuera estadísticamente significativa. En los casos de Lown-Ganong-Levine hubo predominio estadísticamente significativo del sexo femenino
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Síndromes de Pré-Excitação/epidemiologia , Panamá , EletrocardiografiaRESUMO
The aim of this study was to assess the overall prevalence of pre-excitation syndromes and correlate their clinical association with refractory and life-threatening arrhythmias. All electrocardiograms (ECGs) taken at the University Hospital of the West Indies (UWHI) between January and December, 1979 were analyzed for pre-excitation syndromes. Pertinent clinical data were extracted from hospital records. A total of 6,332 ECGs were reviewed. Fifty-two patients (ages 5 to 83 years) with pre-excitation were detected (8 per 1,000). Of these, 43 had the typical delta waves with variable PR intervals and QRS complexes, while 9 had short PR with normal QRS. These syndromes were associated with a broad spectrum of clinical entities, both cardiac and non-cardiac. The majority of patients were free of dysrhythmias (62 per cent), with pre-excitation being an incidental electrocardiographic (ECG) finding. Twenty patients (38 per cent) had significant arrhythmias, the majority of which were supraventricular. In some, these arrhythmias required frequent hospitalizations or clinic visits. At times, the arrhythmias were refractory to drug therapy and responded only to electrical cardioversion. Two of these patients (4 per cent of the series) died in refractory ventricular tachycardia and fibrillation. Both patients had associated Barlow Syndrome. Pre-excitation is not a rare entity in Jamaica. It appears to be a benign incidental ECG finding in the majority of patients seen at UHWI. However, when it is found in patients with the Barlow Syndrome, rheumatic fever and rheumatic heart disease, sickle cell disease with cardiomegaly and infection or renal failure, congestive cardiomyopathy, congenital heart disease and thyrotoxicosis, it can lead to potentially life-threatening arrhythmias. We recommend therefore that careful cardiac assessment be performed in all patients with ECG diagnosis of pre-excitation to detect those patients at high risk of dying suddenly (AU)