Unresolved Issues in Evaluation and Treatment of Preexcitation Syndromes

Abstract

The preexcitation syndromes have been the subject of extensive study, particularly during the last two decades. As a result, we have derived an understanding of both the anatomic substrates of the syndromes and the pathophysiology of its related tachyarrhythmias which far exceeds that of any other disorder associated with cardiac rhythm disturbances. Further, techniques for the precise analysis of the rhythm disorders associated with the preexcitation syndromes have been developed, and a relatively extensive medical and surgical armamentarium for treatment and in some instances of apparent cure of the underlying problem has resulted. Nonetheless, many aspects of the preexcitation syndromes remain to be explored and clarified. The purpose of this chapter is to highlight certain elements of these syndromes in which the final word is not yet in. The list is certainly not comprehensive. However, we hope that it will provide a stimulus for further study of a number of clinically pertinent issues, ultimately leading to both greater insight into these syndromes on the part of interested physicians and scientists and better treatment for patients.