scholarly journals A wide QRS complex tachycardia utilizing an atypical accessory pathway in latent Wolff-Parkinson-White syndrome: Manifestation of anterograde conduction during atrial fibrillation without delta waves in sinus rhythm

2019 ◽  
Vol 5 (8) ◽  
pp. 419-423
Author(s):  
Toshihiro Nakamura ◽  
Koji Fukuzawa ◽  
Jun Kurose ◽  
Hideya Suehiro ◽  
Kensuke Matsumoto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Accessory Pathway ◽  
Qrs Complex ◽  
White Syndrome ◽  
Delta Waves ◽  
Wolff Parkinson White Syndrome

scholarly journals Old stuff still trending. Use of propafenone as a safety net until catheter ablation in a patient with documented pre-excited atrial fibrillation and Wolff-Parkinson-White syndrome—a classic case report

2021 ◽  
Author(s):  
Dimitrios Karelas ◽  
John Papanikolaou ◽  
Charalampos Kossyvakis ◽  
Dimitrios Platogiannis
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Sudden Cardiac Death ◽  
Sinus Rhythm ◽  
Cardiac Death ◽  
Accessory Pathway ◽  
Safety Net ◽  
White Syndrome ◽  
Rr Interval ◽  
Wolff Parkinson White Syndrome

Abstract Background Atrial Fibrillation in Wolff-Parkinson-White syndrome may result in life-threateningly rapid antegrade conduction over a bypass tract, manifested by an irregular broad-complex (pre-excited) tachycardia that can degenerate to ventricular fibrillation. Shortest pre-excited RR interval below 250msec during atrial fibrillation predicts increased risk of sudden cardiac death. Case summary We report a case of a 43-year-old man with unremarkable cardiac history who presented due to sudden-onset feeling of palpitations and pre-syncope after strenuous lifting. Electrocardiography depicted fast pre-excited atrial fibrillation. The shortest pre-excited RR interval was estimated at 160msec, indicating an accessory pathway with short antegrade refractory period at risk for mediating sudden cardiac death. Direct current cardioversion restored sinus rhythm unraveling delta-waves. The patient was put on propafenone 450 mg/day having an uneventful clinical course. On day-10 post-admission, electrophysiological study induced rapid atrial fibrillation but the shortest pre-excited RR interval was substantially increased to 264msec. A left anterolateral accessory pathway was ablated. The patient remained symptom-free until his latest follow-up in the third month post-ablation without manifest pre-excitation on surface electrocardiogram. Discussion Treatment options of pre-excited atrial fibrillation include anti-arrhythmic agents but mainly electrical cardioversion. Cardioversion can safely restore sinus rhythm, while use of anti-arrhythmics often requires ICU monitoring due to risk of QT prolongation. Catheter ablation is the mainstay of therapy for symptomatic patients. Our rare report highlights the direct impact of propafenone on prolonging the refractoriness of the accessory pathway, effectively and safely, and reappraises propafenone’s worthiness as a protective measure following pre-excited atrial fibrillation episode until ablation.

Slow and wide QRS complex tachycardia as a unique complication following radiofrequency catheter ablation of a left-sided accessory pathway in a child

2005 ◽  
Vol 15 (3) ◽  
pp. 315-318 ◽  
Author(s):  
Radu Vatasescu ◽  
Laszlo Kornyei ◽  
Tamas Szili-Torok
Keyword(s):  
Catheter Ablation ◽  
Slow Rate ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Qrs Complex ◽  
White Syndrome ◽  
Accessory Pathways ◽  
Radiofrequency Lesions ◽  
Transaortic Approach ◽  
Wolff Parkinson White Syndrome

Radiofrequency lesions can, theoretically, be the substrate for new persistent arrhythmias. As far as we know, this has never previously been encountered after transcatheter ablation of accessory pathways. A child with Wolff–Parkinson–White syndrome was referred for radiofrequency catheter ablation of a left-sided accessory pathway. After successful ablation of the accessory pathway using a retrograde transaortic approach, the child developed an incessant wide QRS complex tachycardia at slow rate that was resistant to pharmacologic interventions. The focus of the tachycardia was identical to the ventricular site of insertion of the eliminated accessory pathway.

Chaotic atrial tachycardia-related ventricular fibrillation in a 2-month-old baby with Wolff-Pakinson-White syndrome

2010 ◽  
Vol 20 (2) ◽  
pp. 214-217
Author(s):  
Jae K. Ko ◽  
Young H. Kim ◽  
In S. Park
Keyword(s):  
Catheter Ablation ◽  
Ventricular Fibrillation ◽  
Sinus Rhythm ◽  
Growth And Development ◽  
Radiofrequency Catheter Ablation ◽  
Atrial Tachycardia ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Wolff Parkinson White Syndrome

AbstractA 2-month-old baby was resuscitated from ventricular fibrillation attributed to a concurrent chaotic atrial tachycardia with Wolff-Parkinson-White syndrome. He underwent successful radiofrequency catheter ablation of an accessory pathway. Throughout the 4-year follow-up after the procedure, the boy remained free of any drugs, was in sinus rhythm without ventricular pre-excitation and his growth and development were normal.

scholarly journals Cryoablation of a Mahaim Epicardial Accessory Pathway Inside Coronary Sinus Using an 8-mm Catheter

2021 ◽  
pp. 79-83
Author(s):  
Bruno Pereira Valdigem ◽  
Nilton José Carneiro da Silva ◽  
Rogerio Braga Andalaft ◽  
Carla Almeida ◽  
Nilson Araujo Junior ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Sinus ◽  
Accessory Pathway ◽  
Review Literature ◽  
Atrial Fibrillation Ablation ◽  
Low Flow ◽  
White Syndrome ◽  
Ablation Technique ◽  
Wolff Parkinson White Syndrome

Cyoablation is a ablation technique underutilized except in parahissian pathways and atrial fibrillation ablation. Ablation inside venous coronary sinus remains a dreaded incursion, and cryoablation is rarely used. We present the case of a 43 YO female who had a recurrent wolff parkinson white syndrome due to an epicardial pathway inside the coronary sinus successfully treated with a large bore(8mm) cryocatheter. We also review literature and describe the advantages and similar reports of use of cryo in low flow recesses inside the heart.

scholarly journals Progressive Facilitation of Antegrade Conduction via an Accessory Pathway in a Patient with Wolff-Parkinson-White Syndrome and Permanent Atrial Fibrillation

2005 ◽  
Vol 44 (12) ◽  
pp. 1264-1268
Author(s):  
Naohiko TAKAHASHI ◽  
Tatsuhiko OOIE ◽  
Mikiko NAKAGAWA ◽  
Masahide HARA ◽  
Tetsunori SAIKAWA ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Permanent Atrial Fibrillation ◽  
Wolff Parkinson White Syndrome
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