Is there mild preexcitation ?
When is preexcitation mild ?
Left lateral pathway
Revealed with left atrial pacing
Adenosine
Is there mild preexcitation ?
Fasciculoventricular AP
- Mild preexcitation
- Fixed preexcitation
- Preexcitation of junctional beats
- Does not participate in tachycardia
- Not associated with risk of sudden death
Is there preexcitation ?
Preexcitation or no preexcitation with palpitations - Does it matter ?
Does it matter ?
- Preexcitation indicates presence of antegradely conduction accessory pathway
- Small risk of sudden death
- Usually due to rapid conduction of atrial fibrillation leading to ventricular fibrillation
Low risk preexcitation
APERP
SPERRI
Summary
- Suspected mild preexcitation
- Left sided pathway ?
- Fasciculoventricular pathway ?
- Adenosine
- Asymptomatic preexcitation
- Risk of sudden death ?
- Unless risk of sudden death clearly low, EP study