scholarly journals A Brief review of the risks and the stratification of sudden death in the ventricular Pre-excitation syndrome.

2020 ◽  
Vol 33 (4) ◽  
pp. 183-187
Author(s):  
Clóvis Fröemming Junior ◽  
Tiago Luiz Luz Leiria ◽  
Gustavo Glotz de Lima ◽  
Leonardo Martins Pires ◽  
Marcelo Lapa Kruse ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Sudden Death ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Atrial Pacing ◽  
Ebstein Anomaly ◽  
Average Annual Incidence ◽  
European Society Of Cardiology ◽  
Ventricular Preexcitation ◽  
Wolff Parkinson White Syndrome

Objective: The diagnosis of ventricular preexcitation syndromes is often occasional and with underestimated risk, showing controversies in its stratification and indication of prophylactic ablation. This work aims to explore and summarize the data in the literature, exposing the authors’ conclusions regarding this review. Methods: The authors prepared this work based on the latest guideline of the European Society of Cardiology plus a search for articles published in MEDLINE whose titles related to sudden death from ventricular fibrillation in patients with ventricular preexcitation. Discussion: Sudden death secondary to preexcited atrial fibrillation with degeneration to ventricular fibrillation is the most feared event in Wolff-Parkinson-White syndrome, has an average annual incidence of 0.15 to 0.39%, affecting individuals with structurally normal heart. The noninvasive stratification methods do not demonstrate adequate efficacy, and an electrophysiological study is recommended for all cases at the time of diagnosis. The most severe criteria for sudden death are shortest preexcited RR interval ≤ 250 ms (SPERRI or SPRRI); accessory pathway effective refractory period (APERP) ≤ 250 ms; presence of multiple accessory bundles; shortest paced cycle length with preexcitation during atrial pacing ≤ 250ms (SPPCL); Ebstein anomaly; induction of sustained supraventricular tachycardia. Conclusion: The low rate of complications during the diagnostic exam as well as in the therapeutic procedure, added to the high percentage of success of radiofrequency ablation, leads to indicate early the execution of electrophysiological study as a more diligent and accurate measure in the reduction of sudden death events in patients with ventricular preexcitation syndromes.

scholarly journals A case of wide complex tachycardia in wolff-parkinson-white syndrome

2019 ◽  
Vol 6 (4) ◽  
pp. 1
Author(s):  
Jonathan Lowenthal ◽  
Jack Xu ◽  
Eric Pagan ◽  
Richard Tangel ◽  
Daniel Schaer ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Presenting Symptoms ◽  
Wide Complex Tachycardia ◽  
Pr Interval ◽  
History Of ◽  
Ventricular Preexcitation ◽  
Posteroseptal Accessory Pathway ◽  
Wolff Parkinson White Syndrome

The manifestation of atrial flutter, particularly with 1:1 conduction, is rare in patients with ventricular preexcitation secondary to Wolff-Parkinson-White Syndrome (WPW). Very few cases have been reported in the literature. We present a 40-year old male with a history of untreated WPW who presented with severe chest pain and shortness of breath. He was found to have a rapid, regular, wide complex tachycardia. He underwent successful synchronized cardioversion, in which the patient converted tonormal sinus rhythm with classic WPW waveform characteristics, including a shortened PR interval and prolonged QRS complex with a slurred upstroke. Surprisingly, a subsequent electrophysiology study revealed atrial flutter, with bystander conduction of 1:1 atrial flutter being the most likely cause of the patient’s presenting symptoms, and a posteroseptal accessory pathway consistent with the diagnosis of WPW. While considerably rarer than ventricular tachycardia or AVRT, it is nevertheless important for clinicians to consider atrial flutter with 1:1 conduction as a potential diagnosis in patients with WPW presenting with wide complex tachycardia.

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 Wolff-Parkinson-White Syndrome Mimics a Conduction Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
S. Marrakchi ◽  
I. Kammoun ◽  
S. Kachboura
Keyword(s):  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Pacemaker Implantation ◽  
White Syndrome ◽  
Wpw Syndrome ◽  
Conduction Abnormality ◽  
Conduction Disorders ◽  
Associated Conditions ◽  
Wolff Parkinson White Syndrome ◽  
Cardiac Care Unit

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 diagnosing Wolff-Parkinson-White syndrome,Conclusion. A Wolff-Parkinson-White Syndrome may mimic a conduction disease. No reliable algorithm exists for making an ECG diagnosis of a preexcitation syndrome with conduction disorders. This can lead to diagnostic and therapeutic dilemmas in the context of syncope.

scholarly journals Sudden Cardiac Death: The Most Feared but Potentially Preventable Presentation of Wolff-Parkinson-White Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Ana Rita Pereira ◽  
Alexandra Briosa ◽  
Rita Miranda ◽  
Sofia Sequeira Almeida ◽  
Luís Brandão ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Life Support ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Haemodynamic Instability ◽  
White Syndrome ◽  
Asymptomatic Patients ◽  
Wolff Parkinson White Syndrome

Background. Wolff-Parkinson-White syndrome is an uncommon cardiac disorder characterized by the presence of one or more accessory pathways that predispose patients to frequent episodes of arrhythmias. The prognosis is usually good, but there is a lifetime risk of malignant arrhythmias and sudden cardiac death. Case Summary. A 25-year-old male presented a witnessed out-of-hospital cardiac arrest with ventricular fibrillation rhythm. Due to rapid initiation of prehospital advanced life support, return of spontaneous circulation was observed. During the transport to the hospital, an irregular wide complex tachycardia suggestive of preexcited atrial fibrillation with haemodynamic instability was also observed and a synchronized shock was applied. Baseline 12-lead electrocardiogram was compatible with sinus rhythm and ventricular preexcitation pattern. After clinical stabilization, an electrophysiological study was performed confirming the presence of a left anterolateral accessory pathway with a short antegrade effective refractory period. Successful radiofrequency catheter ablation was achieved. Discussion. The reported clinical case recalls fundamental features of the Wolff-Parkinson-White syndrome and outlines the increasing evidence and importance of the invasive risk stratification and even catheter ablation in asymptomatic patients who suffer from this uncommon disease that may have a dramatic and fatal initial clinical manifestation.

Use of electrophysiologic testing to assess risk in children with Wolff-Parkinson-White syndrome

2002 ◽  
Vol 12 (3) ◽  
pp. 248-252 ◽  
Author(s):  
Anne M. Dubin ◽  
Kathryn K. Collins ◽  
Nancy Chiesa ◽  
Debra Hanisch ◽  
George F. Van Hare
Keyword(s):  
Radiofrequency Ablation ◽  
Sudden Death ◽  
Risk Stratification ◽  
Supraventricular Tachycardia ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Asymptomatic Children ◽  
Asymptomatic Patients ◽  
Electrophysiologic Studies ◽  
Wolff Parkinson White Syndrome

In adults with Wolff-Parkinson-White syndrome, the likelihood of sudden death can be estimated based upon the presence or absence of symptoms. Comparable data in children do not exist. To date, therefore, invasive risk stratification has been used to guide management regarding radiofrequency ablation in symptomatic children. As the safety of electrophysiology study and radiofrequency ablation in children has improved, asymptomatic patients have been referred more commonly for invasive risk stratification. We sought to compare the findings from electrophysiologic studies in symptomatic children with Wolff-Parkinson-White syndrome to the findings in asymptomatic children with Wolff-Parkinson-White pattern on their electrocardiogram. Thus, we compared the findings from electrophysiologic studies carried out in patients seen at Stanford University and University of California, San Francisco, from April 1999 to February 2001 with a preexcitation pattern on their electrocardiogram. The patients were divided into three groups: 23 asymptomatic patients studied for risk stratification, 19 patients who presented with syncope, and 77 patients presenting with documented supraventricular tachycardia. Data were collected for commonly accepted invasive criterions for stratification of risk: an effective refractory period of the accessory pathway less than 270 ms, multiple pathways, septal location of pathway, and inducibility of supraventricular tachycardia. Groups were compared by chisquare. No differences were found between the groups for any of the variables. These data suggest that risk factors for sudden death, developed in studies of adult patients, are not clearly applicable to children. Further studies are needed better to define the indications for study and ablation in children.

scholarly journals Iatrogenic Ventricular Fibrillation after Direct-Current Cardioversion of Preexcited Atrial Fibrillation Caused by Inadvertent T-Wave Synchronization

2018 ◽  
Vol 45 (1) ◽  
pp. 39-41 ◽  
Author(s):  
Michael R. Kaufmann ◽  
Matthew S. McKillop ◽  
Thomas A. Burkart ◽  
Mark Panna ◽  
Jamie B. Conti ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ventricular Fibrillation ◽  
Direct Current ◽  
Accessory Pathway ◽  
Qrs Complex ◽  
Energy Delivery ◽  
T Wave ◽  
Direct Current Cardioversion ◽  
Important Means ◽  
Ventricular Preexcitation

Direct-current cardioversion is an important means of managing arrhythmias. During treatment, carefully synchronizing energy delivery to the QRS complex is necessary to avoid ventricular fibrillation caused by a shock during the vulnerable period of ventricular repolarization, that is, a shock on the T wave. The presence of an accessory pathway and ventricular preexcitation can lead to difficulty in distinguishing the QRS complex from the T wave because of bizarre, wide, irregular QRS complexes and prominent repolarization. We present the cases of 2 patients who had iatrogenic ventricular fibrillation from inappropriate T-wave synchronization during direct-current cardioversion of preexcited atrial fibrillation. Our experience shows that rapidly recognizing the iatrogenic cause of VF and immediate treatment with unsynchronized defibrillation can prevent adverse clinical outcomes.

scholarly journals The Clinical and Electrophysiological Features in Patients with Wolff- Parkinson- White Syndrome

2014 ◽  
Vol 10 (1) ◽  
pp. 17-19
Author(s):  
Murari Dhungana ◽  
Sujeeb Rajbhandari ◽  
Kunal Bikram Shaha ◽  
Mukunda Sharma ◽  
Man Bahadur KC
Keyword(s):  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Age Groups ◽  
White Syndrome ◽  
Conducting Pathway ◽  
Male Patients ◽  
Characteristic Features ◽  
Group 2 ◽  
Wolff Parkinson White Syndrome ◽  
Group 1

Background and Aims: Wolff-Parkinson-White Syndrome is a congenital anomaly with delta wave in electrocardiogram representing an accessory conducting pathway. The aim of the present study was to evaluate the characteristic features of patients who underwent electrophysiological study and radiofrequency ablation at Shahid Gangalal National Heart Centre. Methods: One hundred ninety eight patients with Wolff-Parkinson-White syndrome were divided in to three age groups; 1) 8 to 17, 2) 18 to 29 and 3) 30 to 70 years. The clinical, electrophysiological and therapeutic data of these patients were taken retrospectively from the hospital records. Result: A total of 10 (5%) of these patients were less than 18 years of age. There was no sex difference in group 1 and 2. There were significantly more male patients in group 3. There were fewer patients with left sided accessory pathway in group 1 compared to group 2 and 3 (p=0.024 and p=0.002, respectively). Conclusion: This study describes several different electrophysiological characteristics in patients with Wolff-Parkinson-White syndrome. The study showed that the detection of left side accessory pathway was less frequent in children and adolescents with Wolff-Parkinson- White syndrome as well as no gender preponderance in this age group. Nepalese Heart Journal | Volume 10 | No.1 | November 2013| Pages 17-19 DOI: http://dx.doi.org/10.3126/njh.v10i1.9741

Sign in / Sign up

Export Citation Format

Share Document