scholarly journals 136 Blood vortices analysis in children with Wolff–Parkinson–White syndrome

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Nunzia Borrelli ◽  
Giovanni Di Salvo ◽  
Giovanni Domenico Ciriello ◽  
Nicola Grimaldi ◽  
Rosaria Barracano ◽  
...  
Keyword(s):  
Blood Flow ◽  
Left Ventricle ◽  
Global Longitudinal Strain ◽  
Accessory Pathway ◽  
Septal Wall ◽  
White Syndrome ◽  
Av Conduction ◽  
Surface Ecg ◽  
Filling Phase ◽  
Wolff Parkinson White Syndrome

Abstract Aims Wolff–Parkinson–White syndrome (WPW) is a clinical condition characterized by pre-excitation on electrocardiogram (ECG) and symptoms of arrhythmias. It has been described that premature ventricular activation induces septal wall motion abnormalities and ventricular dyssynchrony, causing detrimental effects on cardiac performance. The new speckle-tracking-based technique, blood speckle imaging (BSI), has been previously used to evaluate blood flow characteristics in normal and dysfunctional hearts in patients with normal atrio-ventricular (AV) conduction. We aimed to study the features of left ventricle blood vortices in patients with WPW and short AV conduction by using BSI. Methods and results Nineteen paediatric patients (age 7 ± 2.9 years) were included in the study: 13 patients with manifest WPW (WPW group) and 6 age and sex -matched controls with normal AV conduction (CTR group). A complete echocardiographic evaluation with 2D, color Doppler, and BSI was performed in all the included patients. BSI was recorded in apical 3-chamber view with a 6S-D probe. Vortices characteristics were analysed during the filling phase of the left ventricle. We focused on the anterior vortex generated by the mitral valve, which persisted longer during the cardiac cycle and is assumed to contribute to optimizing cardiac function. For each child in the WPW group, Arruda criteria were used to esteem accessory pathway localization from a 12-lead surface ECG. All patients in the WPW group manifested the accessory pathway in the septal region. All patients in the CTR group presented one major anterior vortex along the septal wall during the filling phase (Figure A), while in the WPW group, 10 patients out of 13 (P = 0.009) lacked this main anterior vortex, showing instead fragmented vortices (Figure B). Interestingly, the main differences in blood vortices pattern were showed in the last part of filling phase, when blood flow could be affected by premature activation of the septal wall. There were no differences in terms of left ventricle function (WPWg 59.8 ± 4.02% vs. CTRg 59.0 ± 2.5%, P = 0.6) and global longitudinal strain (WPWg −18.6 ± 1.0% vs. CTRg −19.6 ± 3.1%, P = 0.5) between the two groups. 136 Figure A and B  Conclusions In our preliminary study, patients with WPW showed a fragmented pattern of diastolic blood vortices that adapted to septal dyssynchrony. We speculate this fragmentation may contribute to impair the performance of the left ventricle.

Radiofrequency Current for Catheter Ablation of Accessory Atrioventricular Connections in Children and Adolescents. Emphasis on the Single-Catheter Technique

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 930-935
Author(s):  
Michael Schlüter ◽  
Karl-Heinz Kuck
Keyword(s):  
Catheter Ablation ◽  
Left Ventricle ◽  
Children And Adolescents ◽  
Accessory Pathway ◽  
Structural Heart Disease ◽  
Right Atrial ◽  
White Syndrome ◽  
Catheter Technique ◽  
Radiofrequency Current ◽  
Wolff Parkinson White Syndrome

Catheter ablation of an accessory atrioventricular connection using 500-kHz radiofrequency current was attempted in 10 children and adolescents aged between 6 and 15 years (mean 10.5 years). Six children had the Wolff-Parkinson-White syndrome and four had tachyarrhythmias related to a retrograde-only conducting ("concealed") accessory connection. No child had associated structural heart disease. Symptoms ranged from disabling palpitations to episodes of syncope (three patients) and cardiac arrest (one patient). Ablation was attempted from the left ventricle in all children; in one child, ablation of a second, right-sided pathway was attempted via a right atrial approach. Ten of the 11 accessory connections were interrupted successfully. A single complication was encountered in a 10-year-old girl in whom the procedure had to be terminated because a thrombotic occlusion of the right internal iliac artery had evolved. A simplification of the ablation procedure associated with reduced procedure duration and radiation exposure time was achieved in three children with th Wolff-Parkinson-White syndrome and a left free-wall accessory pathway when a single catheter placed in the left ventricle was used for pathway localization as well as ablation. It is concluded that catheter ablation using radiofrequency current is effective and safe and may supersede surgery as the curative treatment for children with serious symptoms mediated by an accessory atrioventricular connection.

scholarly journals Use of 3D mapping system for ablating an accessory pathway associated with coronary sinus diverticulum

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohammad Paymard ◽  
Marc W. Deyell ◽  
Santabhanu Chakrabarti ◽  
Zachary W. Laksman ◽  
Jacob Larsen ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Accessory Pathway ◽  
Three Dimensional ◽  
Radiofrequency Energy ◽  
Cardiac Mapping ◽  
Unsuccessful Attempt ◽  
White Syndrome ◽  
Mapping System ◽  
Coronary Sinus Diverticulum ◽  
Wolff Parkinson White Syndrome

Abstract Background This is a rare and challenging case of Wolff–Parkinson–White syndrome due to a posteroseptal accessory pathway located in the coronary sinus diverticulum. It is often difficult to precisely locate this type of accessory pathway, and the ablation procedure could be associated with collateral damage to the neighbouring coronary arteries. Case Presentation The patient was a 49-year-old female with Wolff–Parkinson–White syndrome who was referred for catheter ablation. She had had a previous unsuccessful attempt at ablation and had remained symptomatic despite drug therapy. The pre-procedural cardiac computed tomography scan revealed the presence of a diverticulum in the proximal coronary sinus. Using an advanced three-dimensional cardiac mapping system, the electroanatomic map of the diverticulum was created. The accessory pathway potential was identified within the diverticulum preceding the ventricular insertion. The accessory pathway was then successfully ablated using radiofrequency energy. Conclusion We have demonstrated that the advanced three-dimensional cardiac mapping system plays a very important role in guiding clinicians in order to precisely locate and safely ablate this type of challenging accessory pathway.

MODELING OF WOLFF–PARKINSON–WHITE SYNDROME

2003 ◽  
Vol 13 (12) ◽  
pp. 3827-3834
Author(s):  
ROBERT HINCH
Keyword(s):  
Asymptotic Analysis ◽  
Ion Channel ◽  
Sodium Channel ◽  
Channel Model ◽  
Accessory Pathway ◽  
Simplified Model ◽  
Channel Kinetics ◽  
White Syndrome ◽  
Channel Density ◽  
Wolff Parkinson White Syndrome

Wolff–Parkinson–White syndrome is a disease where an arrhythmia is caused by the ventricles being electrically excited by an additional accessory pathway that links the atria to the ventricles. The spread of the activation wave from this pathway to the ventricles is modeled using a simplified model of Hodgkin–Huxley sodium channel kinetics, in a two ion-channel model. The model is investigated both analytically (using an asymptotic analysis) and numerically, and both methods are shown to give the same result. It is found that for a given width of the accessory pathway, there is a critical sodium channel density needed for the activation wave to spread from the pathway to the tissue. This result provides an explanation for the success of class-I anti-arrhythmic drugs in treating Wolff–Parkinson–White syndrome.

scholarly journals Reversal of systolic dysfunction in noncompaction and Wolff-Parkinson-White syndrome after accessory pathway ablation

2021 ◽  
Author(s):  
Katrin Rezkalla ◽  
Edmund Gatterer ◽  
Matthias Hasun ◽  
Johannes Huber ◽  
Claudia Stöllberger ◽  
...  
Keyword(s):  
Systolic Dysfunction ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Wolff Parkinson White Syndrome

Sevoflurane Has No Effect on Sinoatrial Node Function or on Normal Atrioventricular and Accessory Pathway Conduction in Wolff-Parkinson-White Syndrome during Alfentanil/Midazolam Anesthesia 

1999 ◽  
Vol 90 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Michael D. Sharpe ◽  
Daniel J. Cuillerier ◽  
John K. Lee ◽  
Magdi Basta ◽  
Andrew D. Krahn ◽  
...  
Keyword(s):  
Cycle Length ◽  
Sinoatrial Node ◽  
Sinus Node ◽  
Accessory Pathway ◽  
Atrioventricular Node ◽  
Conduction Time ◽  
White Syndrome ◽  
The Right ◽  
Ablative Procedures ◽  
Wolff Parkinson White Syndrome

Background The effects of sevoflurane on the electrophysiologic properties of the human heart are unknown. This study evaluated the effects of sevoflurane on the electrophysiologic properties of the normal atrioventricular conduction system, and on the accessory pathways in patients with Wolff-Parkinson-White syndrome, to determine its suitability as an anesthetic agent for patients undergoing ablative procedures. Methods Fifteen patients with Wolff-Parkinson-White syndrome undergoing elective radiofrequency catheter ablation were studied. Anesthesia was induced with alfentanil (20-50 microg/kg) and midazolam (0.15 mg/kg), and vecuronium (20 mg) and maintained with alfentanil (0.5 to 2 microg x kg(-1) x min(-1)) and midazolam (1 or 2 mg every 10-15 min, as required). An electrophysiologic study measured the effective refractory period of the right atrium, atrioventricular node, and accessory pathway; the shortest conducted cycle length of the atrioventricular node and accessory pathway during atrial pacing; the effective refractory period of the right ventricle and accessory pathway; and the shortest retrograde conducted cycle length of the accessory pathway during ventricular pacing. Parameters of sinoatrial node function included sinus node recovery time, corrected sinus node recovery time, and sinoatrial conduction time. Intraatrial conduction time and the atrial-His interval were also measured. Characteristics of induced reciprocating tachycardia, including cycle length, atrial-His, His-ventricular, and ventriculoatrial intervals, also were measured. Sevoflurane was administered to achieve an end-tidal concentration of 2% (1 minimum alveolar concentration), and the study measurements were repeated. Results Sevoflurane had no effect on the electrophysiologic parameters of conduction in the normal atrioventricular conduction system or accessory pathway, or during reciprocating tachycardia. However, sevoflurane caused a statistically significant reduction in the sinoatrial conduction time and atrial-His interval but these changes were not clinically important. All accessory pathways were successfully identified and ablated. Conclusions Sevoflurane had no effect on the electrophysiologic nature of the normal atrioventricular or accessory pathway and no clinically important effect on sinoatrial node activity. It is therefore a suitable anesthetic agent for patients undergoing ablative procedures.

scholarly journals -215-PHARMACOKINETIC STUDY OF THE PROCAINAMIDE ON THE ANTEROGRADE CONDUCTION OF THE ACCESSORY PATHWAY IN PATIENTS WITH THE WOLFF-PARKINSON-WHITE SYNDROME

1986 ◽  
Vol 50 (6) ◽  
pp. 522
Author(s):  
Motonobu Hayano ◽  
Hiroshi Nakashima ◽  
Mitsuhiro Tsuruta ◽  
Junichi Inoue ◽  
Yoichi Imamura ◽  
...  
Keyword(s):  
Pharmacokinetic Study ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Wolff Parkinson White Syndrome
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