scholarly journals Intermittent delta waves mimicking inferior myocardial infarction

2014 ◽  
Vol 6 (1) ◽  
pp. 115-116
Author(s):  
Osman Can Yontar ◽  
Erhan Tenekecioglu ◽  
Kermal Karaagac ◽  
Ahmet Tutuncu
Keyword(s):  
Myocardial Infarction ◽  
Accessory Pathway ◽  
Inferior Myocardial Infarction ◽  
Medical Sciences ◽  
White Syndrome ◽  
Delta Waves ◽  
Pr Interval ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White syndrome is recognized with existence of delta waves and a short PR interval on electrocardiogram. Delta waves may appear positive or negative deviated on different derivations corresponding to the location of accessory pathway. In some cases, delta waves mimic Q waves which should be distinguished by physicians. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10802 Asian Journal of Medical Sciences Vol.6(1) 2015 115-116

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.

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.

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