An unusual presentation of Wolff-Parkinson-White syndrome (original) (raw)
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Clinical Cardiology, 1985
Coinciding left bundle-branch block and Wolff-Parkmson-White syndrome type B, a very rare electrocardiographic occurrence, was found in a patient with dilated cadiomyopathy. Electrophysiologic study revealed eccentric retrograde atrial activation during ventricular pacing, suggesting right-sided accessory pathway. At programmed atrial pacing, effective refractory period of the accessory pathway was 3 10 ms; at shorter pacing coupling intervals, normal atrioventricular conduction with left bundle-branch block was seen. Left bundle-branch block was seen also with His bundle pacing. Radionuclide phase imaging demonstrated right ventricular phase advance and left ventricular phase delay; both right and left ventricular phase images revealed broad phase distribution histograms. Combined electrophysiologic and radionuclide investigations are useful to disclose complex conduction abnormalities and their mechanical correlates.
DergiPark (Istanbul University), 2011
Aims: To evaluate the children with electrocardiographic pattern of Wolff-Parkinson-White (WPW) and review their demographic features, presenting symptoms, electrocardiographic, echocardiographic findings, and management. Methods: The study was conducted in a single tertiary research hospital from 2009 to 2011, retrospectively. Twentyone children (1 day to 15 years) with a WPW pattern on surface ECG were included in this study. We classified patients into two groups as "Asymptomatic" and "Symptomatic Group". Results: Most children were asymptomatic (13 cases, mean age: 6.0 years) at the diagnosis and during the study period. Symptoms related to dysrhtyhmia were recognized in 8 cases (mean age: 9.1 years) and most common in school age children. There were no gender predominance between two groups. The symptoms were palpitations in 4 cases and syncope in one case. Three cases presented with attack of supraventricular tachycardia (SVT). They also had intermittent nature of WPW and male predominance. Echocardiography revealed mitral valve prolapsus in 7, hypertrophic cardiomyopathy in 3, aortic regurgitation in 1 and Ebstein abnormality in 1 case. SVT were successfully treated with Amiodoron or Adenosine. No patient died suddenly during the study period. Conclusion: Children with electrocardiographic pattern of WPW should be recognized and managed properly.
Wolff-Parkinson-White syndrome in children: A single-center experience
Eastern Journal of Medicine, 2022
This study aims to evaluate the clinical characteristics and outcomes of children with intermittent and persistent Wol ff-Parkinson-White (WPW) syndrome. Children followed up with the diagnosis of intermittent WPW and WPW syndrome between 2014 and 2022 were reviewed retrospectively. The age, gender, duration of follow-up, admission reasons, electrocardiography (ECG), echocardiography, and ambulatory ECG findings, electrophysiological study and ablation results were analyzed. The study included 99 children with intermittent WPW and 38 children with WPW syndrome. The most common complaints on admission were palpitation (28.5%), murmur (22.6%), and chest pain (19%). Seven of the cases had a history of documented supraventricular tachycardia (SVT) and one of them had SVT on admission. On initial ECG 40.9% and 27.7% of the cases had intermittent and persistent WPW, respectively. Ninety-five (69.4%) cases had a structurally normal heart, whereas congenital heart disease, valvular disease, and mild septal hypertrophy were found in 25 (18.3%), 16 (11.7%), and 1 case, respectively. In the whole study group, 49 (35.8%) cases underwent electrophysiological study (EPS). Five cases had a diagnostic procedure and catheter ablation was performed in 39 (28.5%) cases. Five cases were lost from follow-up after referral for EPS. Recurrence was observed in only one case and none of the cases had any adverse event. Early diagnosis, risk stratification, and appropriate management of patients with WPW syndrome is crucial. The electrophysiological study is used as a risk stratification tool and catheter ablation is a safe curative procedure in high-risk patients.
Clinical and Electrophysiologic Characteristics of the Patients with Wolff-Parkinson-White Syndrome
1997
Background: Antidromic reciprocating tachycardia (ART) is a rare form of wide complex tachycardia in children with Wolff-Parkinson-White syndrome (WPW). The incidence and electrophysiologic characteristics of ART in children with WPW have not been well described. Methods: A multicenter retrospective analysis of all patients with WPW undergoing electrophysiology (EP) study from 1990 to 2009 was performed. Patients with clinical or inducible ART were included. Results: A total of 1,147 patients with WPW underwent EP study and 30 patients had ART (2.6%) and were the subject of this analysis. The mean age was 16 ± 3 years, weight was 65 ± 16 kg, and tachycardia cycle length was 305 ± 55 ms. There were two patients (7%) with congenital heart disease (both with Ebstein's
Wolff-Parkinson-White Syndrome Mimics a Conduction Disease
Case Reports in Medicine, 2014
Background. It is important to recognise Wolff-Parkinson-White (WPW) syndrome in electrocardiograms (ECG), as it may mimic ischaemic heart disease, ventricular hypertrophy, and bundle branch block. Recognising WPW syndrome allows for risk stratification, the identification of associated conditions, and the institution of appropriate management.Objective. The present case showed that electrophysiological study is indicated in patients with abnormal ECG and syncope.Case Report. A 40-year-old man with Wolff-Parkinson-White syndrome was presented to emergency with syncope. A baseline ECG was a complete right branch block and posterior left hemiblock. He was admitted to the cardiac care unit for pacemaker implantation. The atypical figure of complete right branch block and posterior left hemiblock was thought to be a “false positive” of conduction abnormality. But the long anterograde refractory period of the both accessory pathway and atrioventricular conduction may cause difficulty in ...
The Asymptomatic Patient with the Wolff-Parkinson-White Electrocardiogram
Pace-pacing and Clinical Electrophysiology, 1997
Sudden death can be the first manifestation of the Wolff-Parkinson-White (WPW) syndrome. The underlying mechanism being atrial fibrillation with a very high ventricular rate, because of a short anterograde refractory period of the accessory atrioventricular pathway (AP), deteriorating into ventricular fibrillation. Information on the anterograde refractory period of the AP is therefore important to recognize asymptomatic people with the WPW ECG at risk for dying suddenly. Several noninvasive tests are available to identify the low risk patient. Decision making when to interrupt the AP in asymptomatic WPW patients not at low risk requires an invasive study to document the electrophysiological properties of the AP and to determine its exact location.