Introduction
Lown Ganong Levine syndrome or LGL syndrome is a condition that results in pre-excitation of the ventricles. The heart is divided into four chambers- the upper two chambers are called the right and left atrium, and the lower two chambers are called the right and left ventricle. This pre-excitation of the ventricles can be observed in the electrocardiogram of a patient. Pre-excitation of the ventricles refers to the early activation of the chambers of the ventricles. The LGL syndrome or the Lown-Ganong-Levine pattern was initially described by Bernard Lown, William Ganong, and Samual Levine in 1952 and is believed to include an accessory pathway that may completely or partially bypass the atrioventricular or AV node leading to the direct activation of His bundle by the sinoatrial or SA node.
The atrioventricular conduction is the normal electrical impulse conduction between the atrium and the ventricles. The AV node, or the atrioventricular node, is a tiny structure in the heart. The chief function of this atrioventricular node is to control the flow of the heart’s electrical signals that are getting transmitted from the atrium to the ventricles. On the other hand, this HPS or the His-Purkinje System has the duty to rapidly conduct the electrical signals to the ventricles. The Lown Ganong Levine syndrome displays a pattern of the normal QRS complex and a short PR interval on the electrocardiograph.
What Are the Causes of Lown Ganong Levine Syndrome?
There is no definite cause established as of today for Lown Ganong Levine syndrome. The theory regarding the cause of this syndrome is stipulated as follows.
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Wolff-Parkinson-White or WPW is generally recognized as the cause for pre-excitation of the ventricles.
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Multiple underlying manifestations may result in the complete or partial bypass of the atrioventricular node.
What Are the Signs and Symptoms of Lown Ganong Levine Syndrome?
The Lown-Ganong-Levine syndrome has been reported in several age groups of patients and has not displayed any increase in the incidence in either the genders or ethnic races. Bernard Lown, William Ganong, and Samual Levine had an initial study that revealed approximately two hundred electrocardiograms of thirteen thousand evaluated patients displaying a short PR interval along with a normal QRS complex. Thus the rate of prevalence of Lown Ganong Levine syndrome corresponds to merely 1 %.
Mentioned below are a few signs and symptoms of Lown Ganong Levine syndrome.
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A history of paroxysmal atrial fibrillation.
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A history of atrial arrhythmias.
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Palpitations.
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The irregular rhythm of the heart.
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Increase in thyroid hormone.
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Abnormal electrolyte balance of the body.
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Increase or decrease in potassium levels.
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Increase or decrease in magnesium levels.
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The resting electrocardiogram displays a pattern of normal QRS complex but a short PR interval.
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Supraventricular tachycardia.
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Escalated stroke output.
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Reduced cardiac output.
How Can Lown Ganong Levine Syndrome Be Diagnosed?
There are several diagnostic tools for the diagnosis and confirmation of Lown Ganong Levine syndrome. Mentioned below are a few of them. It should be noted that a diagnosis to confirm the presence of Lown Ganong Levine syndrome only takes place after a thorough physical and medical examination but this syndrome has the tendency to not have any clinical manifestation at all. The classic sign of Lown Ganong Levine syndrome is a normal QRS complex with a short PR interval.
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Electrocardiogram.
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Electrophysiological study of the heart.
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Routine auscultation.
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Palpation of the arteries.
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Blood tests to determine thyroid levels.
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Blood picture of the electrolyte of the body, especially magnesium and potassium.
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Vagal maneuvers.
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Holter monitors.
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Implantable loop recorders.
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Absence of atrial fibrillation.
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Presence of paroxysmal supraventricular tachycardia.
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Absence of atrial flutter.
What Is the Treatment for Lown Ganong Levine Syndrome?
Treatment of Lown-Ganong-Levine is presently focused on the utilization of antiarrhythmic drugs. Mentioned below are the various treatment modalities and the management plan for Lown Ganong Levine syndrome.
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Radiofrequency catheter ablation.
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Prevention of tachyarrhythmias through the accessory pathway.
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Antiarrhythmic medications.
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Reducing the atrioventricular nodal conduction.
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Increasing the refractory period.
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Sodium channel blocking medications.
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Pacemaker implantation.
Conclusion
Lown Ganong Levine syndrome is a pattern of the heart that results in immature or early excitation of the heart's lower chambers, called ventricles. This condition is rare and thus is difficult to diagnose due to less information being established as of today. Lown-Ganong-Levine syndrome is mostly seen in women of young age as well as middle-aged women. Lown Ganong Levine syndrome leads to decreased cardiac output in the long run due to overuse of the ventricles. The condition has several diagnostic tests to be detected, and treatment depends on the severity as well as the clinical manifestations that the patient presents themselves with. Lown Ganong Levine syndrome is treatable, and the patient needs to follow the advice and suggestion of the healthcare provider.
