Preexcitation syndromes

diagnostic consideration in the ED

Mark, Dustin G. MD
Brady, William J. MD
Pines, Jesse M. MD, MBA, MSCE

^aDepartment of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
^bCenter for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
^cThe Leonard Davis Institute Of Health Economics, University of Pennsylvania, Philadelphia, PA 19104, USA
^dUniversity of Virginia Health Sciences Center, Charlottesville, VA 22908, USA

Received 10 June 2008; accepted 16 June 2008

^*Corresponding author. Tel.:+1 215 662 4050.

American Journal of Emergency Medicine 27(7):p 878-888, September 2009.

Abstract

Preexcitation syndromes are a common cause of paroxysmal tachycardias presenting to the ED. Emergency physicians should be familiar with the common electrocardiographic manifestations of preexcitation, particularly the Wolff-Parkinson-White abnormality, as these conditions require specific therapeutic management. This article reviews the pathophysiology of preexcitation, along with the electrocardiographic findings of Wolff-Parkinson-White and its associated tachyarrhythmias.