Classification and peculiarities of overcoming Wolf Parkinson White's syndrome. Center for Cardiology and Functional Diagnostics

Wolff-Parkinson-White syndrome ( WPW syndrome) - clinical-electrocardiographic syndrome, which is characterized by pre-excitation of shlunochki after additional atrioventricular paths, carried out and development of paroxysmal tachyarrhythmias. WPW syndrome suffers from small arrhythmias: supra-mucous tachycardia, fibrillation or pain in the front of the heart, anterior to the heart, and supra-systoles with occasional sub-sympathetic breast cancer). Diagnosis of WPW syndrome is based on donations from the EKG, additional EKG-monitoring, EchoKG, CHPEKS, EED. The treatment of WPW syndrome can include antiarrhythmic therapy, through extravagant electrocardiostimulation, catheter mirch.

Wolff-Parkinson-White syndrome (WPW syndrome) is a syndrome of early excitement of shlunochkіv, rumination of impulses carried out on additional abnormal conduction beams, which are located in front of the heart and wormholes. The widening of WPW syndrome, according to cardiology data, is 0.15-2%. WPW syndrome is more common among people; in a large number of vipadkiv manifest to a young person(10-20 years), older - in older people. The clinically important meaning of WPW syndrome is that, with its manifestation, important damage often develops heart rhythm, As a threat to the life of a sick person and in the process of making special trips to the disease.

Causes of WPW Syndrome

On the thought of a greater number of authors, WPW syndrome, the accumulation of preservation of pre-existing atrioventricular diseases as a result of incomplete cardiogenesis. At the same time, there is an incomplete regression of the fibrous fibers on the stage of formation of fibrous cells of the tricuspid and mitral valves.

At the norm of the prescripts, there are nobles, so that the front of the head and the louse can be drawn, and all the embryos are on the early stages development, a little step-by-step to stink, to speed up and to become aware of the next development. When the formation of fibrous atrioventricular cells is damaged, the fibers of the fibers are stored and form the anatomical basis of WPW syndrome. Unimportant to the inclinations of the character of pre-datkovyh AV-z'єdnan, WPW syndrome can manifest itself in any future for the first time. With the same form of WPW syndrome, there are often many additional atrioventricular conditions.

In 30% of patients with WPW syndrome, congestion of heart tissue (abnormalities of Ebstein, prolapse of the mitral valve, defects of the anterior and mid-mucous membrane septum, tetralogy of Fallo), disembrophysiogenetic

Classification of WPW syndrome

For the recommendation of the WHO, to develop the phenomenon and the WPW syndrome. The WPW phenomenon is characterized by electrocardiographic signs of the conduction of an impulse according to additional conditions and pre-excitation of shlunochki, but without key manifestations AB reciprocal tachycardia (re-entry). Because of WPW syndrome, rely on additional pre-excitation of slugs with symptomatic tachycardia.

The urahuvannya of the morphological substrate see a few anatomical variants in WPW syndrome.

I. Dodatkovy meazovy AV-fibers:

• how to go through dodatkove liva abo right parietal AV-z'єdnannya
• how to go through the aortic-mitri fibrous tissue
• how to go towards the head of the right or left front of the heart
• tied over the aneurysm of the sinus of Valsalvi or the middle vein of the heart
• septal, paraseptal upper and lower

II. Three special-purpose muscular AV-fibers ("Kent's bundles"), which are transformed from the rudimentary, analogous structures of the atrioventricular university, fabrics:

• atrio-fasciular - enter into the right lower part of the Gis bundle
• to enter the myocardium of the right crotch.

Some of the most common forms of WPW syndrome are seen:

• a) manifestu - with a permanent manifestation of delta-khvili, sinus rhythm and episodes of atrioventricular reciprocal tachycardia.
• b) intermittent - with the time-dependent pre-excitation of the slings, sinus rhythm and verification of the atrioventricular reciprocal tachycardia.
• c) prikhovanu - with retrograde conduction along the pre-atrioventricular atrioventricular z'єdnannyu. Electrocardiographic signs of WPW syndrome do not appear, є epizodia of atrioventricular reciprocal tachycardia.

Pathogenesis of WPW syndrome

The WPW syndrome is widespread from the anterior to the shlunochkiv after anomalous paths. As a result of the destruction of a part, or of the entire myocardium of the shlunochki, it will appear earlier, lower, when the pulse is widened, by a rapid path - along the AV-unit, the bundle and the heads of the Gis. The pre-excitation of the shlunochkіv is displayed on the electrocardiogram at the viglyadі of the pre-datum depolarization - delta-hvili. The P-Q (R) interval is short, and the triviality of the QRS increases.

If the main feature of depolarization comes into the slings, it will be rebuilt in the heart of the so-called evil QRS complex, which is a old spike deformed and expanded. Atypical inconveniences in supernatant sufferers of damage after repolarization processes, such as viraz on the EKG in those who are discordant to the QRS complex;

The diagnosis of WPW syndromes, paroxysms of supraventricular tachycardia, severe and three-pronged atrium is associated with the form of circular congestion (re-entry). In general, the impulse along the AB-vuzl collapses into the anterograde straight (from the front of the nose to the shlunochkiv), and along the dodatk paths - in the retrograde straight (from the shlunochkiv to the front of the heart).

Symptoms of WPW Syndrome

Clinical Manifestation of WPW Syndrome is seen in any case, before it may be asymptomatic. WPW syndrome is associated with low heart rhythm disorders: reciprocal supraventricular tachycardia (80%), AF (15-30%), anterior tachycardia (5%) at a frequency of 280-320 beats. in hv. In some cases of WPW syndrome, there are fewer specific arrhythmias - atrial and shlunochkova extrasystole, shlunochkova tachycardia.

Attack arrhythmia can winikati under the infusion of emotional abo physical overstrain, alcohol malignancy abo spontaneously, for no apparent reason. Before the hour of the artillery attack, there is a feeling of heart and heart, of cardialgia, of a good marriage. Merekhtinnya and trifling in front of the heart of superfluousness, unpleasantness, dullness, hypotensiveness; during the transition to the fibrillation of shlunochkiv, there may come a raptus heart death.

Paroxysms of arrhythmias in WPW syndrome can be trivial from several seconds to several years; Some smells to bathe on their own, or if you see reflexive receptions. Prolonged paroxysms in the hospitalization of a sick person and the involvement of a cardiologist.

Diagnosis of WPW syndrome

In case of suspicion for WPW syndrome, complex clinical and instrumental diagnostics is carried out: ECG in 12 cases, transthoracic echocardiography, Holter ECG monitoring, transesophageal electrocardiostimulation dosage, electrophysiology.

Prior to electrocardiographic criteria, WPW syndrome can be considered: short PQ-interval (less than 0.12 s), deformations of the malignant QRS-complex, manifestation of delta-hvili. Dobove EKG monitors will be stagnant for the past to break the rhythm. When the ultrasound scan is carried out, the heart will reveal itself to the heart, cardiomyopathy.

Carrying out ChSES with WPW syndromes allows to bring the presence of additional paths to the conduct, indukuvati paroxysms of arrhythmias. Endocardial EED allows for the exact number of localization and number of additional nobles, verification key form WPW syndrome, vibration and efficiency assessment drug therapy abo Mіrcha. differential diagnostics to conduct WPW syndrome with blockade of the Gis bundle.

Lіkuvannya syndrome WPW

When there are attacks of arrhythmia, WPW syndrome is not in the form of special treatment. In case of hemodynamically significant attacks, supravodzhuyutsya syncope, angina pectoris, hypotension, growths are signs of heart failure, followed by a negative signal electrical cardioversion or CHSES.

Reflex vagal maneuvers (massage of the carotid sinus, Valsalvi's test), intravenous injection of ATF, and blockers of calcium channels, antihypertensive drugs, antihypertensive drugs, antihypertensive drugs (antihypertensive drugs) Post-antiarrhythmic therapy is indicated for patients with WPW syndrome.

In case of resistance to antiarrhythmic drugs, the development of AF is performed by catheter radio-frequency ablation of pre-existing pathways by means of transaortic (retrograde) or transseptal access. The efficiency of Mirch in WPW syndromes reaches 95%, the risk of relapses is 5-8%.

Forecast and prevention of WPW syndrome

Patients with asymptomatic surges in WPW syndrome have a prognosis of sagging. Likuvannya and caution is necessary only for persons who may be involved in a family history of rapture deaths and professional indications (for athletes, donors, and others). In the presence of scarg or life-threatening arrhythmias, it is necessary to carry out a complete complex of diagnostics for the selection of the optimal method of treatment.

Patients with WPW syndrome (including those who have suffered from Mirch) require the caution of a cardiologist-arrhythmologist and cardiohirurgist. Prevention of WPW syndrome is secondary in nature and in antiarrhythmic therapy for prevention of recurrent episodes of arrhythmias.

One of the diseases of the heart-vascular system is Wolf Parkinson White's syndrome. The disease is a heart dysfunction, tied to the rooted muscle of impulses in the muscle. The WPW syndrome of names after people was first described by White Doctors and Wolf Parkinson.

WPW syndrome - a childish anomaly

In the norm, the speed of the forehead and the shlunochkiv are seen on the go. Їх wickle impulses, like go from the sinus vuz. Smell go to the atrium, and then to the atrioventricular point. Tsey shlyakh to be the norm. In case of anomalies, the impulse collapses along additional channels, for which reason it is not necessary before. The pre-excitation of slugs is generated. Anomalies lead to the development of serous depressions of the heart rhythm - tachyarrhythmias.

The syndrome does not get widened. Diagnostics of fewer than one hundred people. An ear of growth is often lost to a childish, adult or youthful vik. The older the process of starting up in older people. The syndrome can be asymptomatic and manifest itself in any person. Choloviks are more mentally ill, but not women.

Causes of development syndrome

WPW Heart Syndrome is a sign of becoming ill. Yogo provokuyut dodatkovі atrioventricular development, as in the early stages of intrauterine development of people є in the cutaneous membrane. With a normal interruption, the stench begins to groan step by step and during the twentieth time of vaginosity. In case of anomalies, the development of the canal will become overwhelmed. Cardiogenesis is such a rank to be left incomplete.

SVC syndrome can be transmitted to children from fathers

Approximately in the third of the infections, the SVC syndrome will coexist with heart defects and dressings with them. Mova, for example, about Ebstein's anomalies, mitral valve prolapse and others. When a sick person is sick, the partitions of the heart are deformed, with the resulting fabrics suffer from the process of dysplasia, which leads to the development of the syndrome.

The ERW can be of a deciduous nature. As pathology is diagnosed in relatives, pre-existing canals often appear not alone, but helpless.

Unimportant to congenitality, to a good business for not yes about themselves the nobility called. Provokuvati the development of such officials:

• ominous alcohol;
• kurnnya;
• stress;
• often emocyne zbujennya;
• addicted to kawi.

Find out the anomaly bazhano yakomog earlier, so you can save yourself a little faster. The ERW syndrome of the heart will become a great threat to my life.

Shkіdlіvі svіtіvі nіvіtazhennya can become a "shipment" for the formation of pathology

Classification of disease

Physicians are mentally inclined to fall ill for the syndrome and the phenomenon. For the first characteristic anomalies and symptoms. Phenomenon of the transmission of only broken hearts in the view of the early canals. Show your sickness at a new day. All іsnu chotiri forma:

• Manifest is characterized by antegrade (from start to finish) and retrograde passages of impulses. Symptomatic picture is twisted.
• Ghosting syndrome WPW - impulses move along the additional channels only retrograde. Zakvoryuvannya protіk in prikhovanіy formі. It is unfortunate to find an ailment behind the aid of electrocardiograms.
• Intermittently, or alternate syndrome - the impulse slides antegradely along the pre-gradual, then along the main path. Cardiogram fiksuє pre-excitation, and even after a decal of seconds it does not appear.
• The running syndrome WPW is a pre-excitation of slugs to be repeated periodically. Anomalies are not permanent. You don't need to wait for the ailment. Vona niyak does not give a trivial hour about the nobility, the cardiogram will show the norm. As long as the patient's symptoms are visible, to speak not about the syndrome, but about the WPW phenomenon.

Fallow classic paintings see chotiri formy get sick

Also WPW syndrome type A and type B. The first one is more prevalent. With a new way, roztashovuyutsya in the left part of the heart. The pre-excitation poddaetsya vidpovidny slung. The other is characterized by the prototypal localization of the channels. Anomalous "behavior" of the right crotch is detected.

symptomatic picture

Symptoms of Wolff Parkinson White's syndrome may not appear all at once, but rather on a daily basis. Even before forty rockies, the nobility is not allowed about itself, it is better for everything; The asymptomatic form is rarely transformed into іnshu.

Periodic manifestation of ailment is characterized by intermittent WPW syndrome and timchasovia. Attack the sickness of the building, provokuvati physical or emotional overwhelming, the implantation of alcohol, the courtyard. Ale the most frequent self-esteem is lost for no apparent reason.

The head symptom of the syndrome is a breakdown in the rhythm, with any patient seeing a pulsation, heart heart in the breasts, yogo zavmirannya. People can be good if they start to get lost.

ERV syndrome

With the help of the following signs:

• zamorochennya;
• zadishka;
• Significant weakness;
• noise in the vuha;
• b_l behind the breastbone.

Once an hour the attack will move forward. Serious vapadas have unpleasantness. Most often arrhythmia appears in the early childish... I didn’t think about it until five rockies, but it’s 25% of the symptoms to be aware of it. You can conceive for an hour or so, but later the latency interruptions to relapses.

The triviality of attacks varies from seconds to years. At the same time, the frequency of all ailments is good. Inodi arrhythmia yes about themselves the nobility a couple of times on the ric, and someone is tormented today. In the last drop, a seryoznaya is required medical aid... Beat until the likary followed by another or third attack.

Frequently attack sick people who are superfluous

diagnostics of illness

As a rule, you can see signs of WPW syndrome on the EKG (electrocardiogram). The doctor started making a history. In the course of a conversation with a patient, I’ll talk about the specialness of my ailments (for some circumstances, there is a part of the rhythm, some trifling attacks, and some symptoms).

Also, there is a manifestation of heart-like ailments in close relatives, with a family history. Another important step is a visual look. Take until uvagi:

• views of shkirnykh curves;
• mill nigtyovyh platesі hair;
• the periodicity of the dichotomy and its particularity (the presence of wheezing in the legends of chi ni);
• noise in the heart.

Schob viclyuchiti abo wiyaviti ailments, Persh nіzh nіzh nіzhdіnu lіdina pіdnuyu on Wolf Parkinson White syndrome on EKG, laboratory analyzes are carried out. On the hall, the slaughter is taken. If there is blood, then such an analysis will be more biochemical and hormonal.

Show pathology of a doctor can be noted when looking at a patient

Electrocardiography, how to pass the patients, who developed with the symptoms described above, it is necessary to show specific changes in the robot's heart. Delta hvilya on the EKG is easy to fix at the moment of pre-excitation of the slut. However, do not expect Danish method Regularity to bring results.

With some forms of WPW disease, the syndrome does not appear on the EKG. To clarify the picture, freeze:

• Dobovy monitoring of electrocardiograms by Holter.
• Echocardiography, which allows the appearance of abnormal changes in the structure of the heart meat.
• Electrophysical dosages, when a probe is introduced through the stravochid to the heart area, and the behavior of the muzzle is clearly fixed. You can also use special tachycardia attacks for analysis of special features.
• Elektrofiziologicheskie obsozhennya, with which the probe is introduced through the stegnum vein directly into the heart mucus. The staff of the whole drug will accept accurate information.

The EHC does not want to allow the diagnosis of the presence of pathology

As a result of the complex situation, an accurate diagnosis is established. It’s possible to lay down the tactics of lіkuvannya, yak will be stuck.

ways of lіkuvannya

If arrhythmia is not carried out when sick at night, treatment of SVC syndrome is not carried out. In some types, they can be conservative and surgical. Persistent transmission of antiarrhythmic drugs for antiarrhythmic attacks (Kordaron, Propanorm).

However, not all of the groups can be treated with ailments from IDPs. Before sampling, the hearts of glucosides, β-adrenergic blockers are introduced. In any case, it is not possible to recognize the drug on its own. Deyakі lіki zdatnі often ruin the camp and lead to non-gated inheritance.

To take a sercebitta dopomagaє injected onto the bloating nerve. Yogo nadayut, with peace of mind pushing on very apple pivkhvili. Another way is to tame the energy and force the muscles of the abdomen.

Effectively treating WPW syndrome - radio frequency ablation. Vona transferring neutralization of the clitin, scho viclikayut the broken rhythm, with an electric strum. Remaining access to the heart is provided for the catheter opening. The operation is not considered to be surgical, it is minimally invasive. It is carried out with muscular anesthesia.

Regularly attack a sick person to serve as indicated for the operation

Hirurgical treatment for Wolf Parkinson White's syndrome is indicated for frequent attacks (more than one per day), but not effective conservative methods for їх indispensability (young vіk). Likewise, up to Mіrcha, there is vdajutsya, as the syndrome supravodutsya impaired blood circulation, uncomfortable, swirling hypotonia or weakness.

Forecast and prevention

Have an affliction, which is asymptomatic, has a prognosis of a liking. Likuvannya vono is not vimag, contraindicated to robots and sports with SVC syndrome, such a form is not voiced by doctors. Ale dotrimuvatisya gold middle - obov'yazkovo. Re-assignment of admission is not possible.

With a turn of symptomatic picture rapt death from arrhythmia insistence rіdko. Such vipadk_v are less than one vidotka. Rizik advances through the reception of antiarrhythmic actions.

Special prophylaxis of pathology of nema, splinters of ailment vrodzhen. For people who have SVC syndrome on the EKG, or with the help of other methods, it is shown unique shkіdlivyh ringtone, Physical and emotional re-entanglement. Smells guilty regularly take drugs and take antiarrhythmic drugs to prevent attacks. Samolikuvannya with this ailment is included.

The video will tell you in detail about the peculiarities of overcoming the SVC syndrome in children:

Wolff-Parkinson-White (WPW) Syndrome is developed rather tricky, protesting through a rich-faceted picture is "tricky" for EKG-diagnostics.

For the EKG picture, the Wolf-Parkinson-White (WPW) syndrome is characterized by a shorter PQ interval (less than 0.12 s), an extension and deformation of the QRS complex, a configuration of what is called a blockade of the lower heart rate, the appearance of a delta-hip deformity.

In case of WPW syndrome, the heart is overwhelmed by two paths. At a time, the myocardium of a single louse is sent through a supplementary driveway, then it is carried out by a normal way through the AV-vuzol.

Wolff-Parkinson-White (WPW) syndrome is often diagnosed in young adults. For a new type of attack, paroxysmal tachycardia (AV-vuzlova tachycardia).

Wolff-Parkinson-White syndrome(WPW) named after the authors, first described it in 1930 (Wolf, Parkinson and White). The incidence of increased syndrome is low and it fluctuates in the range of 1.6-3.3%, if the middle of the sick with paroxysmal tachycardia on the th part of the attack from 5 to 25% of the cases of tachycardia.

importance diagnostics of Wolff-Parkinson-White syndrome(WPW) is tied with a team that, for their EHCs, has shown a lot of problems with a heart and a pardon in diagnostics. That WPW syndrome gets involved in "tricky" illnesses.

Pathophysiology of Wolff-Parkinson-White (WPW) syndrome

When (WPW) the myocardium is stimulated with two paths. In most cases, the cause of the syndrome of congestions is an additional bundle of conduction, and the precursor bundle itself, or a bundle of Kent, which serves as a short path widened from the front of the head to the bow. The price can be represented by such a rank.

ruin vinika, Yak call, u sinus node, Ale will expand along the pre-wired road, like a guessed beam of Kent, reach the shlunochka shvidshe and earlier, lower with the extravagant expansion. As a result, there is a pre-excitation of a part of the louse (pre-excitation).

Slid for cim to ruin insha part of shlunochkiv as a result of the hopefulness of impulses in them along the normal path, the path goes along the path to pass through the AV-z'udnannya.

Symptoms of Wolff-Parkinson-White (WPW) syndrome

for Wolff-Parkinson-White syndrome (WPW) Characteristics of the offensive 3 key signs:

Due to numerical reasons, WPW syndrome occurs more often in men than in women; 60% of cases of WPW syndrome are reported in a part of the population of a young person.

The ailments of Wolff-Parkinson-White (WPW) syndrome often skew on heartbeats, or wiclicans to disturbed heart rhythms. In 60% of patients with ailments, arrhythmias are susceptible to arrhythmias, paroxysmal suprashlunochkova tachycardia (reciprocal AV-nodal tachycardia). In addition, there can be a small atrium, an atrium, an atrium and extrasystole, as well as AV block I and II stages.

In 60% of cases, Wolff-Parkinson-White (WPW) syndrome occurs in people who do not have scarg on the side of the heart. Celebrate individuals who suffer vegetative dystonia... In the last 40% of cases, WPW syndrome is diagnosed in ailments with heart pathology;

Diagnosis of Wolff-Parkinson-White (WPW) syndrome

Diagnosis of Wolff-Parkinson-White syndrome(WPW) is available only with the assistance of the EHC. With respectful reading, it is possible to create a clear picture: for a normal P wave, there is an unviable PQ interval, the triviality is less than 0.12 s. The norm has a triviality to the PQ interval, as already mentioned in the distribution assigned normal EHC, Dorivnyu 0.12-0.21 s. Raising the PQ interval (for example, with AV block) dear ones Heart, at that hour there is a rapid interval, a rare phenomenon, which is practically used only for WPW and LGL syndromes.

The rest is characterized by a short PQ interval and a normal QRS complex.

We are important EHC-I acquaintє Change to the QRS complex. This is the name of the delta-hvilya for the first ear, because we have given them a kind of a unique look and we can expand them (0.12 s and more). In the bag, the QRS complex appears to be expanded and deformed. Win can be nagaduvati for the shape of the snake, characteristic of the blockade of PNPG, and in part of the vipadkiv - LNPG.

scraps depolarization of shlunochki(The QRS complex) is clearly changed, then the repolarization is recognized as secondary changes, so that the ST interval is captured. So, with WPW syndrome, viral depression of the ST segment and negative prong T in all breast insertions, the first for everything, in the V5 and V6 insertions.

Dali obviously, when Wolff-Parkinson-White syndrome(WPW) the narrower and wider Q-wave in the II, III and aVF insertions is not too fast to resurrect. In such cases, the diagnosis of the ІМ back stage is possible. Ale inodi is clearly broadened and a large Q wave is restructuring in the right pectoral insertions, for example, in the V1 and V2 insertions.

Lack of information fahіvets in such a way can pomilkovo diagnostics of myocardial infarction(IM) front wall of LSh. If there is sufficient evidence, as a rule, it is possible to enter into entries II, III, aVF or V1 and V2 diagnostics of delta-hvilya, which is characteristic of WPW syndrome. In all thoracic insertions V5 and V6, the delta-wave is straightened down, so the Q wave is not differentiated.

Treatment for WPW syndrome, which manifests itself as a clinical symptomatology, is repaired for lykarsky zasobiv, For example, aymaline or adenosine, for which, as a result of the daytime, it should be inserted before catheter ablation before the catheter ablation to carry out a path, as it should be brought to a level of 94% of the volume. In case of asymptomatic excess of WPW syndrome, special therapy is not required.

Features of EKG in Wolff-Parkinson-White (WPW) syndrome:
Speed ​​interval PQ (<0,12 с)
Determination of delta-khvili on the EKG
A change to the configuration of the QRS complex, which will cause a blockade of the lower bundle of the gas (PG)
Paroxysmal tachycardia (AV-vuzlova tachycardia)
To be seen in young people, who often have a heart defect

SVC syndrome - in short

Wolff-Parkinson-White syndrome Kent beam), Yakiy to create a rhythm to the breaking point.

Dodatkovy providny bundle restructuring in ailments from the people, ale the first symptoms become susceptible to the disease.

In small patients, rhythm disturbances in SVC syndrome are not safe for life.

Lіkuvannya sіdroma VPV hirurgicne - ruinuvannya predatkovogo to carry out the path using surgical methods.

Symptoms of SVC syndrome

Expanded SVC symptoms:

• heart rate
• heartbeat
• dirty
• svidka stomachability in case of physical replacement
• obscurity

Symptoms appear in the first place in the adolescence, as already stated. SVC - congenital syndrome. The reason for the appearance of an additional bundle is genetic. Sometimes the rhythm is broken from a few seconds to a few years, and more often to develop with physical adjustment. The appearance of symptoms can be provoked by the intake of drugs, or an excess of coffee in the day, in one - the course.

In more important cases, especially if the SVC syndrome is caught up in the heart, the symptoms may come on:

• the severity of the breast cancer
• zadishka
• rapt death

In the early days of the preschool age, it’s not like the symptoms and symptoms appear only with the knowledge of the EHC.

SVC syndrome - report

The heart of the people is stored from the chambers - the right and left front of the heart and the right and left lingering. Rhythm, with the heart speeding up, setting the water to the rhythm, wrinkling in the right atrium and being called sinus vuzom(The correct rhythm is called sinus rhythm).

From the sinus unit of generation їm the electric pulse expands along the atriums and go to the іnshiy university located between the atrium and the dumbbell (anteroventricular or atrioventricular AV-vuzol). AV-vuzol trochi spovilnyu conduction of an impulse. The price is necessary in order for the little ones to get up like blood from the front of the heart. We will not be able to pick up an electric pulse here. In the case of SVC syndrome between the front of the arteries and the lugs, there is a small additional conductive path, which is found in the AV-unit bypass.

To what can you bring? Electric impulse zanadto shvidko reachє shlunochkіv - vinikє tzv. pre-examination.

Moreover, the electric impulse can be consumed in a loop and then circulate in a circle between the front of the heart and with the slings from the even great shvidkistyu - vinikє takhіkardіya (shvidke sertsebittya) by type re-center(Re-entry). Such a tachycardia is not unbeatable for all the time, shlunochki, zanadto quickly fast, but do not rise up like blood, and my heart is idle, but do not pump blood or pump out a lot of dull hearts (decrease).

Visibility, for it means lowering the heart wikid to catastrophic legacies:

• in a big way - until the raptor death
• before the fall of the arterial grip
• until the loss of blood
• to the ischemia of the heart (as the heart is not ready to receive blood through the system of coronary arteries)

It may be that the problem is that the electrical impulses fix the price rise on the front of the head chaotically, the chaotic speed goes up. Such a camp is called the front of the heart (or fibrillation of the front). Chaotic impulses from the anterior can lead to quickening and quickening of shlunochki, so again to reduce the heart wikid.

Debilitation with ERW

If you take a look around the sick doctor, I mean:

• Electrocardiogram. On the EKG (navіt with the appearance of symptoms), you can see a special prong from the pre-period to carry out a path (delta-hvilya) and accelerate the conduction of an electric impulse in front of the hearts and with dumbbells.

• EHC for 24 years - t.v. holterivske monitoring. The patient is a portable device of the EKG by pulling it out, and then recording is analyzed. Holter monitoring through its triviality and even more information about the heart rhythm, lower than the EKG.
• Electrophysiological dosage. From the hour of admission of special catheters with electrodes, they are inserted through the blood vessels to the small heart, which allows the localization of the supplementary bundle to be accurately detected (more by means of this zruynuvati). By the way, the electrophysiological dosage is a type of EKG, with a large number of electrodes. Often elektrofiziologicheskihne dlіdzhennya to go with lіkuvannya - with radio frequency catheter ablation (Div. Nizche).

Elimination of SVC syndrome

non-surgical behavior

With the development of tachycardia, you can try to trust the rhythm in the following ways:

• vagus probes. Vagus probes or vagal maneuvers - the process of stimulation of the bloating nerve (vagus nerve), which is a hopeful heart rhythm. Before vagal tests, stress is applied, massage of the carotid sinus (receptor point on the carotid artery) and in.
• if vagal probes do not supplement, stagnate medication without drugs - inject (intravenously, inject naturally only drugs) antiarrhythmic drugs (increase in the amount of arrhythmia type - amiodarone, phytonutrient) - blockers, for example, esmolol).
• electrical cardioversion - to get sick when the patient is unstable, because drug therapy is ineffective. With an electric cardioversion, behind the aid of a defibrillator in a special synchronization mode, it is at the heart of the patient's anesthesia to be given a straining electric pulse, which "drowns out" all anomalous water rhythm, and the "core" turned back into sync.

Children who have been diagnosed with arrhythmias need antiarrhythmic drugs in a continuous mode, mainly for those who are not shown to carry out radioablation.

Surgery for SVV syndrome

Radio frequency catheter ablation- the most common procedure in the treatment of SVC syndrome. Likar lead the catheter through the blood vessel to the heart in the middle of the passage of the anomalous bundle and the ruptured bundle behind the additional high-frequency electric pulse. The procedure is carried out with muscle anesthesia. The efficiency is close to 100%. Folding for new births.

Rapidly eliminating the Wolf-Parkinson-White syndrome is stagnant in Danish hour, in the main along the way, as cardiological operation from the drive is required.

The WPW syndrome is a pathology in the nerve fibers of the heart meat, which attacked the tachycardia and was accompanied by the passage of an anxious nerve impulse along additional shortened paths that are visible in a healthy heart.

first answers

In 1930, Russian physicians Wolf, Parkinson and White were the first to describe the signs and mechanism of manifesting a syndrome, for which I have given the name SVC syndrome (WPW). I am also an insight, like a WPW phenomenon. You can also see it in the tsy statty.

At the norm of fibers in the heart, as to conduct a nervous, sleepy pulse, they set up a singing route, which will prevent an equal step in increasing the pulse. Generation of a signal to be repaired in the sinus node in the right atrium, reaching the AV-node (atrioventricular vuzole) in the anterior-ventricular zone, then along the tips of the gus bundle through the damaged synchronous fibers, such as all of the heart's ointment.

Causes and symptoms

In case of WPW syndrome, it is necessary to pass through a short path to the so-called Kent bundle, minayuchi from the anterior to the bowels, pass along a short path to the so-called Kent's bundle, minayuchi the anterior-bowel (AV) vuzol. In order to hvilya zbudzhennya pass more quickly, not at a normal rhythm of the heart, as a result of discoordination in the fast heart meat and the development of arrhythmias.

To break down the path of the heart pulse.

Such anomalies in the heart of Budovia are inherently innate and form decayingly through a deformed gene, or for the flow of other factors, unpleasantly pouring on the development of the heart of the human embryo.

In the fetus, there is a presence of additional atrioventricular rings and fibers, which, up to the 20-22nd development, grow groaning and become more aware. Also, such fibers are stored, anatomical changes of mind, and WPW syndrome. The spadkov form of WPW syndrome develops into a manifestation of the great number of AV-z'udnan, and of anomalies in Budov's heart. However, unaffected by the appearance of anatomical views, the first can appear only in a mature person. With the increase in the manifestation of this syndrome, 70% appear in the choloviks.

signs of pathology

Some of the broader signs of possible manifestation of WPW syndrome onset:

1. Seeing a strong and frequent heartbreak, as children can be called "wistribu or kalataє heart".
2. Raptovo zamorochennya.
3. Unreasonable obscurity, a big world in a childish and childish life.
4. Squeeze pain in the heart, poke and laugh pain when inhaling.
5. Seeing instability, strong backsliding even in a young person.
6. Newly born women can be seen during the year of bathing, they can be bright, persistent weakness, the frequency of heart rate periodically increases up to 200-300 strokes in khiliina.

Yak viyaviti get sick?

In a great number of people who may have additional pathological fibers in the heart muscle, WPW syndrome is diagnosed, only if it is done.

Such a syndrome does not suffer from attacks of tachycardia, for arrhythmias, and it may not be suspicious about the manifestation of pathologies in the heart.

Also, asymptomatic persists in 35-40% of all emerging nose syndrome. Easy steps against WPW syndrome are characterized by intermittent short-hour tachycardia or arrhythmia, which can pass quickly without outside help. For usunennya attacks in times of moderate severity WPW syndrome requires antiarrhythmic drugs, such as blockers of heart damage.

In some trivial attacks, which practically do not know about medication, and to slow down with unhealthy speed and heart disease, an important stage of the syndrome is diagnosed and it is recommended to promptly remedy it.

tipi syndrome

WPW heart syndrome is also classified according to the frequency and peculiarities of the appearance of different key signs and to the following types:

• Manifest, if on the electrocardiogram there is a continuous presence of delta-hvilya, and the AVR-tachycardia and sinus rhythm are episodic.
• The past is characterized by the past of the pre-excitation of the slugs.
• Prikhovaniy is described as an episodic ABP-tachycardia, but in a calm state it is not diagnosed.

How can you diagnose the syndrome?

Without electrocardiograms, the diagnosis of WPW syndrome is possible by hearing the tones of the heart, as there are parts of the bends of an irregular character, as well as by the irregularity of the pulse.

Krim EKG, diagnostics of WPW syndrome is carried out by monitoring, in addition to a special portable device with electrodes, by the method of ultrasonic monitoring and echocardiography, the introduction of a stimulating electrode into the condition of a complex deciphering of such a bundles of Kent and permissively recommend a conservative or prompt treatment.

WPW phenomenon

When there was a certainty of WPW syndrome in more than 30% of cases of noses in the syndrome, there was no evidence of scarg on the health of the heart. In connection with a great number of similar asymptomatic ones, in 1980 the WHO published recommendations, in which WPW syndrome was distributed, which is a very important picture, and WPW-phenomenon.

About such a phenomenon, there is a tendency to fear, if on the electrocardiogram of the heart the sinus rhythm is indicative of an early awakening of shlunochki, protest at the presence of certain pathological conditions and atrioventricular tachycardia did not deteriorate.

Unimportant on the price, with the phenomenon of WPW, the risk of diagnosis is even higher; In an older population, in 0.3% of cases, the WPW-phenomenon is caused to fatal inheritances, in more mature children, in 2% of cases, there are serious deaths.

Statistics of the WPW phenomenon in children

WPW syndrome borrows more than a few factors, which is why children suffer from tachycardia and arrhythmia. Win is an obvious base for those who have been sick to the rhythm of the heart, and to reduce the frequency of scarg not to reduce the risk of any other pathologies. Whether it is a physical advancement, intensive sports, psychological officials can provoke a clearly safe heart activity and lead to death of a heart attack.

Trivial caution stretching over 20 years for a great group of children, who have WPW heart syndrome, and all newcomers up to 18 years have shown good results:

• 8% of children saw raptas attacked by ABP-tachycardia;
• in 8.2% of those who have experienced a transition of the phenomenon into a transitional WPW syndrome;
• 8.5% had short hours of trawling;
• 2% of children had already suffered major deaths before the first time;
• 1.2% - only lads - died in rape during the period of time;
• only 9% of children with the WPW phenomenon have been registered with the signs.

Chim is the not without WPW phenomenon?

From the hover numbers you can see that it is not safe to see the manifestation of the WPW phenomenon. Such a high rate of diagnosis of uncomfortable symptoms and pathologies even in a child's life, let it be tolerated, but without friendly physical and emotional options, without monitoring and carrying out hundreds of upcoming visits

Children with the WPW phenomenon are not guilty of engaging in professional sports and enduring stresses. It is safe to put up to the sharp changes to the climes of calls, as well as strong emotional splashes. All the factors can lead to serious illness or death. Individuals, in which the manifestation of the WPW phenomenon is established, is not called up to the service.

Treatment and elimination of the syndrome

Symptoms and methods of treatment are often interconnected. There are many drug-free drugs that indicate a person with WPW syndrome, and also reduce the manifestation of these symptoms.

A group of drugs-blockers normalizes the frequency of very heart meat. However, the effectiveness of such conditions is manifested only at the level of 50-60%, and it is not possible to get rid of it in case of persistent hypotonia and asthma.

Antiarrhythmic drugs to finish stably relieve the attack of AVP-tachycardia, normalize the heart rate in 80% of patients, however, there are also a number of indications for cases of hypotonia, infarction, and other pathological heart disease. Deyakі kaltsієvі blockers categorically contraindicated in the syndrome of WPW, so as on the basis of the picture of transmission of the nerve impulse of the stench give a stench in the robot in front of the heart, as there are no serious inheritances.

Also, in the number of types of intake of drugs in the group of ATP, there is a negative injection into the fast frontal area. There are also non-drug methods for stopping the syndrome.

In the tissue of the tissue, the nerves pass through the pretty and parasympathetic fibers. The first type of fibers activates the heart of the robot, another type of trusting heart is fast, being a type of the bloating nerve nervus vagus, and is also called the vagal reflex. To activate the very given type of reflexes give the effect of stabilization of the robot's heart. The easiest way to activate vagal impulses is the Ashner reflex, which is provoked by 20-30-second slight onslaught on an internal apple and is often supplemented with zupiniti tachycardia.

Also, the bloody nerve is kindly activated by the reaction and tension of the abdominal muscles, so in case of the syndrome, or the WPW phenomenon, it is criminally engaged in yoga and mental gymnastics.

It is possible to launch an important signal through an electrode, injections into a stravohid, even more efficiently zupinyaє important trivial tachycardia, or even to bring up to a fibrillation of a heartbeat, to be afraid in special cabinets, owned.

Defibrillation is carried out only in even more important situations, when there is a threat to life, Alevon often additionally helps to squeeze some non-safe alternate third-party impulses in the heart tissue and normalize the rhythm of the robot's heart.

Operative methods for the treatment of WPW syndrome and the need

The WPW phenomenon has been detected on the EKG, the operative method of usuning is stagnant only in especially folding vipads, with parts and prolonged tachycardia, as you do not know medication, as well as with the occurrence of vapors of rapid death of the heart of the heart.

It is promptly recommended only on the basis of all-purpose and general coverage, as it will give the most accurate picture of the structure of pathological tissues in the heart. Tom should think about the ones that work with the WPW phenomenon.

The operation is carried out behind the help of a special electrodes, which is introduced through the stegnous artery into the heart mucus for additional X-ray surveillance and in the singing dylyanka viroblyaє radiooprіzhіganіe, ablation, fibers of the nerve tissue.

The destruction of pathological nerve fibers can also be carried out. And in that, and in general, the efficiency of the operation reaches 95%. Relapses trap for reasons of uncommon ruinuvannya to be absorbed in the field, as well as in the presence of the other non-evolved nervous tissue. The operation itself can be performed under muscle anesthesia, it is practically bloodless, it is not fast-paced, even for a short period of time, and it can be carried out at any time.

near Moscow

Institute of Surgery IM. A.V. Vishnevsky is the pride of scientific medicine, in its own way, in its own way, by the way of conducting research and diagnostics, to carry out scientific advancement, development of high-tech diagnostics and uniqueness of cardiology. FSBI “NNP Center of the Heart-Sudden Surgery im. A. N. Bakulєva "zdіysnu lіkuvalnu, science and illumination activities for the program" Heart-Sudinna surgery ".

The Russian cardiological scientific-virobnichesky complex to carry out the maintenance and development of the heart on the high-tech light industry. At the center "CardioDom" you can go beyond cardiological treatment, and consider it as therapeutic treatment in outpatient departments. Cardiological centers in Moscow have recommended themselves for good, so if there is a need for prompt involvement, it is possible to do this without thinking.