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Introduction
Preexcitation usually refers to early impulses along the bypass tract can be quite
depolarization of the ventricles by an variable and may be only intermittent or rate-
abnormal pathway from atria. Rarely, more dependent. Bypass tracts can conduct in both
than one such pathway is present. The most direction, retrograde only (ventricle to atria)
common form of preexcitation is due to the or, rarely, anterograde only (atrium to
presence of an accessory pathway (bundle of ventricle)2 (Figure-2). The most prominent
Kent) that connects one of the atria with one manifestation of ventricular preexcitation is
of the ventricles (Figure-1)1. Wolff-Parkinson-White (WPW) syndrome3.
2
Rabiul MA Preexcitation Syndrome presented with Ventricular tachycardia – A Case Report
pathway produces a short PR interval in reentry tachycardia (AVNRT) and can mimic
ECG and a ‘slurring’ of QRS complex, bundle branch block, right ventricular
called ‘delta wave’ (Figure-5). The ECG hypertrophy, ischaemia, myocardial
appearance of this tachycardia may be infarction, and ventricular tachycardia
indistinguishable from that of AV nodal (during atrial fibrillation)7.
3
Rabiul MA Preexcitation Syndrome presented with Ventricular tachycardia – A Case Report
Conclusion
Preexcitation akin various morbid care providers, specially paramedics should
tachyarrythmias on monitor. Quick and be thoroughly conversant, familiar and
correct recognition of cardiac dysrhythmias updated to the management of moribund
is the hallmark of managing the critically ill patients by continuing medical education and
patients in intensive care settings. Health bed-sides clinics.
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