8,231 results on '"Wolff–Parkinson–White syndrome"'
Search Results
2. Wolf-Parkinson-White Syndrome and Asymptomatic Pre-excitation in Africa (a Multicenter WPW African Registry)
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- 2024
3. Stress ECG Test for the Evaluation of the Risk of Sudden Cardiac Death in a Paediatric Cohort With WPW Pattern
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Christian Balmer, Head of Electrophysiology, principal investigator, clinical lecturer
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- 2024
4. What an anesthesiologist should know about pediatric arrhythmias.
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Kuntz, Michael T., Eagle, Susan S., Dalal, Aarti, Samouil, Marc M., Staudt, Genevieve E., and Londergan, Bevan P.
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VENTRICULAR tachycardia , *VENTRICULAR arrhythmia , *SUPRAVENTRICULAR tachycardia , *LONG QT syndrome , *CHILD patients , *ARRHYTHMIA - Abstract
Identifying and treating pediatric arrhythmias is essential for pediatric anesthesiologists. Pediatric patients can present with narrow or wide complex tachycardias, though the former is more common. Patients with inherited channelopathies or cardiomyopathies are at increased risk. Since most pediatric patients present for anesthesia without a baseline electrocardiogram, the first identification of an arrhythmia may occur under general anesthesia. Supraventricular tachycardia, the most common pediatric tachyarrhythmia, represents a broad category of predominately narrow complex tachycardias. Stimulating events including intubation, vascular guidewire manipulation, and surgical stimulation can trigger episodes. Valsalva maneuvers are unreliable as treatment, making adenosine or other intravenous antiarrhythmics the preferred acute therapy. Reentrant tachycardias are the most common supraventricular tachycardia in pediatric patients, including atrioventricular reciprocating tachycardia (due to a distinct accessory pathway) and atrioventricular nodal reentrant tachycardia (due to an accessory pathway within the atrioventricular node). Patients with ventricular preexcitation, often referred to as Wolff‐Parkinson‐White syndrome, have a wide QRS with short PR interval, indicating antegrade conduction through the accessory pathway. These patients are at risk for sudden death if atrial fibrillation degenerates into ventricular fibrillation over a high‐risk accessory pathway. Automatic tachycardias, such as atrial tachycardia and junctional ectopic tachycardia, are causes of supraventricular tachycardia in pediatric patients, the latter most typically noted after cardiac surgery. Patients with inherited arrhythmia syndromes, such as congenital long QT syndrome, are at risk of developing ventricular arrhythmias such as polymorphic ventricular tachycardia (Torsades de Pointes) which can be exacerbated by QT prolonging medications. Patients with catecholaminergic polymorphic ventricular tachycardia are at particular risk for developing bidirectional ventricular tachycardia or ventricular fibrillation during exogenous or endogenous catecholamine surges. Non‐selective beta blockers are first line for most forms of long QT syndrome as well as catecholaminergic polymorphic ventricular tachycardia. Anesthesiologists should review the impact of medications on the QT interval and transmural dispersion of repolarization, to limit increasing the risk of Torsades de Pointes in patients with long QT syndrome. This review explores the key anesthetic considerations for these arrhythmias. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Dual challenge inside the womb: a case report of concomitant fetal atrio-ventricular block associated with maternal antiSSA antibodies and fetal tachyarrhythmia diagnosed as Wolff-Parkinson-White syndrome after birth.
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Teodósio Chícharo, Ana, Rebelo, Mónica, Rita Lopes, Ana, João Saavedra, Maria, Filipa Paramés, Maria, Rita Araújo, Ana, Rita Cruz-Machado, Ana, Pinto, Luísa, and Capela, Susana
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WOLFF-Parkinson-White syndrome ,ATRIOVENTRICULAR node ,HYDROPS fetalis ,DISEASE risk factors ,HEART block ,AUTOANTIBODIES - Abstract
Fetal autoimmune atrioventricular block (AVB) is a rare but potentially lifethreatening condition. It results from the passage of maternal anti-SSA/Ro or Anti SSB/La auto-antibodies into the fetal circulation, leading to inflammation and fibrosis of the AV node and often to irreversible damage. Besides AVB, these antibodies can also cause cardiomyopathies, but there is no evidence linking them to tachyarrhythmias. We present the case of a patient with significant risk factors for fetal AVB: a prior history of hydrops fetalis, high anti-SSA/Ro antibody levels and hypothyroidism. In this case, the use of dexamethasone and intravenous immunoglobulin may have contributed to reversing the first degree atrioventricular block detected at 19 weeks of gestation. Additionally, at 21 weeks, the fetus developed a tachyarrhythmia that needed treatment with flecainide. Soon after the birth, the newborn underwent ECG Holter and Wolff-Parkinson-White Syndrome (WPWS) was diagnosed. To our knowledge, the coexistence of fetal AVB and WPWS has never been described. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Pregnancy outcomes in patients complicated with pre-excitation syndrome.
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Wang, Kana, Xin, Junguo, Hu, Qing, Wang, Xiaodong, and Yu, Haiyan
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WOLFF-Parkinson-White syndrome , *PREGNANCY outcomes , *FETAL distress , *GESTATIONAL diabetes , *PREGNANCY complications , *PREGNANT women , *SUPRAVENTRICULAR tachycardia - Abstract
Introduction: Pregnant women with pre-excitation syndrome are more likely to develop supraventricular tachycardia (SVT) during pregnancy and delivery, leading to an increased risk of adverse events. Method: This was a retrospective study of 309 pregnancies in 280 women (29 women had two pregnancies in this series) with pre-excitation syndrome who delivered at West China Second University Hospital from June 2011 to October 2021. All the 309 pregnant women with pre-excitation syndrome were divided into SVT and non-SVT groups to analyze the cardiac and obstetric complications. Results: Among the included pregnant women in the past 10 years, the prevalence of pre-excitation syndrome was 0.24% (309/127725). There were 309 cases with pre-excitation syndrome in all hospitalized pregnant women. Among them, 62 (20.1%, 62/309) had a history of SVT. In the 62 cases with SVT during pregnancy, 22 (35.5%) cases had a history of SVT. Gestational diabetes mellitus was associated with SVT during pregnancy. The cesarean section rate was 88.7% in the SVT group, which was significantly higher than that in the non-SVT group (64.8%) (P < 0.001). Cases with SVT during pregnancy had more cardiac and obstetric complications. Four fetal deaths were recorded in the SVT group. Additionally, 29 women experienced two pregnancies during the study period, among whom, five received radiofrequency ablation after the first delivery and obtained better outcomes in the second pregnancy. Conclusion: The adverse outcomes such as cardiac complications, maternal and fetal complications (PROM, prematurity, SGA, fetal distress, etc.) in pregnant women with pre-excitation syndrome were closely related to SVT, with possible risk factors including history of SVT before pregnancy, cardiac function, heart organic abnormalities, and gestational diabetes mellitus. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Evaluation of T‐wave memory after accessory pathway ablation in pediatric patients with Wolff‐Parkinson‐White syndrome.
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Duras, Ensar, Sulu, Ayse, Kafali, Hasan Candas, Sisko, Sezen Gulumser, Caran, Bahar, and Ergul, Yakup
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WOLFF-Parkinson-White syndrome , *ABLATION techniques , *RETROSPECTIVE studies , *ELECTROCARDIOGRAPHY , *HEART conduction system , *MEDICAL records , *ACQUISITION of data - Abstract
Background: T‐wave memory (TWM) is a rare cause of T‐wave inversion (TWI). Alterations in ventricular activation due to abnormal depolarization may cause repolarization abnormalities on the ECG, even if myocardial conduction returns to normal. These repolarization changes are defined as TWM. In our study, we aimed to determine the frequency of TWM development and the predictors affecting it in the pediatric population who underwent accessory pathway (AP) ablation due to Wolff‐Parkinson‐White (WPW) syndrome. Methods: The data of patients with manifest AP who underwent electrophysiological studies and ablation between 2015 and 2021 were retrospectively analyzed. The study included 180 patients who were under 21 years of age and had at least one year of follow‐up after ablation. Patients with structural heart disease, intermittent WPWs, recurrent ablation, other arrhythmia substrates, and those with less than one‐year follow‐up were excluded from the study. The ECG data of the patients before the procedure, in the first 24 h after the procedure, three months, and in the first year were recorded. The standard ablation technique was used in all patients. Results: Postprocedure TWM was observed in 116 (64.4%) patients. Ninety‐three patients (51.7%) had a right‐sided AP, and 87 patients (48.3%) had a left‐sided AP. The presence of posteroseptal AP was found to be significantly higher in the group that developed TWM. Of these patients, 107 (93.1%) patients showed improvement at the end of the first year. Preprocedural absolute QRS‐T angle, postprocedural PR interval, and right posteroseptal pathway location were identified as predictors of TWM. Conclusion: The development of TWM is particularly associated with the right‐sided pathway location, especially the right posteroseptal pathway location. The predictors of TWM are the preprocedural QRS‐T angle, the postprocedural PR interval, and the presence of the right posteroseptal AP. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Hide and seek: Masking of preexcitation from a slow‐conducting, decremental right lateral accessory pathway due to preexcitation via a fasciculoventricular pathway.
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Kohli, Utkarsh and Hoda, Mehar
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WOLFF-Parkinson-White syndrome ,RARE diseases ,DECISION making ,HEART conduction system ,ELECTROCARDIOGRAPHY ,TACHYCARDIA ,CARDIAC arrest ,ELECTROPHYSIOLOGY - Published
- 2024
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9. JCS/JHRS 2022 Guideline on Diagnosis and Risk Assessment of Arrhythmia.
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Takase, Bonpei, Ikeda, Takanori, Shimizu, Wataru, Abe, Haruhiko, Aiba, Takeshi, Chinushi, Masaomi, Koba, Shinji, Kusano, Kengo, Niwano, Shinichi, Takahashi, Naohiko, Takatsuki, Seiji, Tanno, Kaoru, Watanabe, Eiichi, Yoshioka, Koichiro, Amino, Mari, Fujino, Tadashi, Iwasaki, Yu‐ki, Kohno, Ritsuko, Kinoshita, Toshio, and Kurita, Yasuo
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ATRIAL fibrillation diagnosis ,ARRHYTHMIA diagnosis ,BRADYCARDIA diagnosis ,TACHYCARDIA diagnosis ,MYOCARDIAL infarction diagnosis ,SARCOIDOSIS diagnosis ,BRUGADA syndrome diagnosis ,CONGENITAL heart disease diagnosis ,ATRIAL fibrillation risk factors ,RISK assessment ,MEDICAL protocols ,PLETHYSMOGRAPHY ,MYOCARDIAL ischemia ,WOLFF-Parkinson-White syndrome ,VENTRICULAR ejection fraction ,BUNDLE-branch block ,LONG QT syndrome ,SICK sinus syndrome ,ABLATION techniques ,CARDIOMYOPATHIES ,EXERCISE ,DIFFERENTIAL diagnosis ,ARTIFICIAL intelligence ,SYNCOPE ,AMBULATORY electrocardiography ,WEARABLE technology ,SEVERITY of illness index ,SUPRAVENTRICULAR tachycardia ,CARDIAC hypertrophy ,DILATED cardiomyopathy ,VENTRICULAR fibrillation ,FAMILY history (Medicine) ,MEDICALLY unexplained symptoms ,MAGNETIC resonance imaging ,ARRHYTHMIA ,ELECTROCARDIOGRAPHY ,VENTRICULAR tachycardia ,DEEP learning ,VENTRICULAR arrhythmia ,ISCHEMIC stroke ,EXERCISE tolerance ,IMPLANTABLE cardioverter-defibrillators ,CARDIAC arrest ,BLOOD pressure testing machines ,CARDIAC pacemakers ,AUTONOMIC nervous system diseases ,ATRIAL flutter ,CARDIAC pacing ,HEART block ,CEREBRAL infarction ,CORONARY artery disease ,GENETIC testing ,ELECTROPHYSIOLOGY ,CARDIAC surgery ,RADIONUCLIDE imaging ,ECHOCARDIOGRAPHY ,EVALUATION ,DISEASE risk factors - Published
- 2024
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10. Ablation of accessory pathways in different anatomic locations using focal pulsed field ablation.
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Brešković, Toni, Lisica, Lucija, Jurišić, Zrinka, Petrović, Davor, Sikirić, Ivan, Metličić, Vitomir, and Anić, Ante
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Ablation of accessory pathways (APs) is the cornerstone for treatment of patients with Wolff-Parkinson-White syndrome and manifestation of atrioventricular reentrant tachycardia. Pulsed field ablation (PFA) is a new type of nonthermal energy source delivered to the underlying tissue via the ablation catheter and used for ablation of arrhythmic substrates. The purpose of this study was to determine the efficiency and long-term outcome of ablation of APs of different localizations using a focal pulsed electrical field. Electrophysiological study was performed in patients with indication for AP ablation. An ablation catheter was used to map the position of AP insertion. Pulsed electric field was delivered through a standard ablation catheter. In left-sided APs, the first ablation attempt was within the coronary sinus (CS). Patient follow-up was scheduled 1–3 months after the ablation. Additional check-up was performed after 6 and 12 months. Fourteen 14 patients (3 pediatric) were treated. Termination of AP conduction was achieved in all procedures. The cohort consisted of 3 right free wall, 3 posteroseptal, and 8 left-sided APs. Ablation through CS was successfully used in 7 of 8 patients with left-sided APs. No complications were reported. Median follow-up was 5.5 months. Conduction recurrence through AP was documented in 1 patient. Focal PFA for AP shows promising results in terms of efficacy and safety. A high rate of successful termination of left-sided APs by ablation within CS may represent a new standard approach. The safety and efficacy profile of PFA seems to be transferable to the pediatric population. [ABSTRACT FROM AUTHOR]
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- 2024
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11. PRKAG2 Variant, Motor Neuron Disease, and Parkinsonism: Fortuitous Association or a Potentially Underestimated Pathophysiological Mechanism?
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Marco Orsini, Wladimir Bocca Vieira de Rezende Pinto, Paulo Sgobbi, and Acary Souza Bulle Oliveira
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motor neuron disease ,amyotrophic lateral sclerosis ,parkinsonism ,Wolff–Parkinson–White syndrome ,cardiomyopathy ,PRKAG2 ,Physiology ,QP1-981 ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
A 72-year-old Brazilian woman presented with a 4-year history of rest tremors of the hands, followed by slowness of movement, and a diagnosis of idiopathic Parkinson’s disease. She was started on dopamine agonists with significant improvement. After three years, she complained about slowly progressive dysphagia, dysphonia, quadriparesis, and cramps and fasciculations. A neurological examination disclosed distal-dominant quadriparesis, dysarthria, atrophy and fasciculation of the tongue, global brisk tendon reflexes, fasciculations, bilateral ankle clonus, and moderate spasticity of the lower limbs. She had also palpitations, dyspnea, and one episode of paroxysmal atrial fibrillation. Electrocardiography revealed a short PR interval, a widened QRS complex, and the delta wave, suggestive of Wolff–Parkinson–White syndrome. Brain and spine MR imaging, a cerebrospinal fluid analysis, and general serum lab exams were unremarkable. Needle electromyography disclosed chronic denervation involving cervical, thoracic, lumbosacral, and bulbar levels associated with acute denervation, including positive sharp waves, fasciculations, and fibrillation potentials. This patient fulfilled the diagnostic criteria for amyotrophic lateral sclerosis associated with parkinsonism. A broad next-generation sequencing-based panel disclosed the presence of the novel heterozygous variant c.1247C > T (p.Pro416Leu) in the PRKAG2 gene (NM_016203.4). Clinicians must be aware of the possibility of PRKAG2 variants in complex clinical scenarios associating cardiac arrhythmia, preexcitation syndromes, hypertrophic cardiomyopathy, motor neuron disease, and parkinsonism.
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- 2024
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12. Localization of Accessory Pathways in Patients with Wolff-Parkinson-White Syndrome Using Cross-Recurrence Plot of Precordial Leads
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Sakineh Yahyazadeh, Nader Jafarnia Dabanloo, Ali Motie Nasrabadi, and Alireza Ghorbani Sharif
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wolff-parkinson-white syndrome ,localization ,accessory pathway ,cross-recurrence plot. ,Telecommunication ,TK5101-6720 - Abstract
The non-invasive localization of accessory pathway (AP) in patients with Wolff-Parkinson-White (WPW) syndrome is typically performed upon physicians’ diagnoses based on observing their electrocardiogram (ECG) signals, which are not always the same. Therefore, a high-accuracy automatic method can help minimize this gap regarding AP localization. This study was to develop a novel semi-automatic localization of AP in patients with WPW syndrome, using features selected from the cross-recurrence plot (CRP) of consecutive precordial leads on ECG. The study participants comprised of 31 patients with WPW syndrome (aged 8-69, with the mean age of 31.19±14.69, 32.3% female), receiving successful ablation therapy during the first session. The features extracted from the CRP, including laminarity (LAM), trapping time (TT), determinism (DET), and mean length of diagonal line (L) were then analyzed. The feature reduction, The classification and the cross-validation (CV) methods were sequential forward selection (SFS), the k-nearest neighbors (KNN) and the leave-one-out (LOO) respectively. The proposed method could differentiate the right and left APs in the patients with WPW syndrome with the accuracy value of 87% (sensitivity: 93.33%, specificity: 81.25%). These results were achieved by the LAM and L features from the CRP of (V1, V2) and (V3, V4), respectively.
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- 2024
13. Sotalol prophylaxis was efficient and safe for supraventricular tachycardia in early infancy.
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Evertsson, Caroline, Eliasson, Håkan, and Halvorsen, Cecilia Pegelow
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SUPRAVENTRICULAR tachycardia , *INFANTS , *WOLFF-Parkinson-White syndrome , *PROARRHYTHMIA , *TERMINATION of treatment - Abstract
Aim Method Results Conclusion There is no consensus on the best prophylaxis for supraventricular tachycardia (SVT) in infancy. We studied the efficacy and safety of sotalol.This retrospective study comprised infants diagnosed with SVT before 1 year of age and treated with sotalol during 2002–2018 in Stockholm, Sweden. The patients' characteristics, comorbidities, sotalol dosages, QT intervals and outcomes were extracted from their medical records.We studied 85 infants (65% boys) with a median age of eight (range 0–288) days at the time of diagnosis, including 78 with re‐entry tachycardia. Sotalol was completely or partially successful in the 67/75 patients who completed the treatment, as well as in four of the seven patients with other tachycardia mechanisms. The 48 infants with postnatal debut had significantly higher success rates than the 27 with foetal debut (96% vs. 78%, p = 0.04). Prolongation of corrected QT (QTc) intervals of ≥450 ms occurred in 16% of the total cohort and two patients with QTc intervals of ≥500 ms had their treatment changed. There were no cases of proarrhythmia after sotalol treatment.Sotalol provided effective and safe prophylaxis for SVT during infancy. QTc prolongation rarely caused treatment discontinuation and there were no cases of proarrhythmia. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Transformation of a tachycardia following a His‐refractory premature ventricular complex: What is the mechanism?
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Vivekanantham, Hari, Mtwesi, Viwe, and Divakara Menon, Syamkumar M.
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ACTION potentials , *WOLFF-Parkinson-White syndrome , *SUPRAVENTRICULAR tachycardia , *RADIO frequency therapy , *VENTRICULAR tachycardia , *ARRHYTHMIA , *HEART conduction system , *ELECTROCARDIOGRAPHY , *HEART beat , *HIS bundle , *CATHETER ablation , *ATRIOVENTRICULAR node , *ELECTROPHYSIOLOGY - Abstract
The article presents a case study of a 69-year-old female who underwent an electrophysiological study due to recurrent supraventricular tachycardia (SVT). It highlighted the occurrence of a wide complex tachycardia (WCT) and explored the mechanism behind its transformation following a premature ventricular complex (PVC). Treatment discussed involved radiofrequency ablation targeting the base of the triangle of Koch, which successfully eliminated SVT inducibility and potentially the NFV pathway.
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- 2024
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15. Wolff-Parkinson-White Syndrome in the Preterm Neonate.
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Jadczak, Elizabeth A. and Jnah, Amy J.
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WOLFF-Parkinson-White syndrome treatment ,INTERVERTEBRAL disk abnormalities ,EDUCATION of parents ,CESAREAN section ,PROPRANOLOL ,WOLFF-Parkinson-White syndrome ,PHYSIOLOGIC salines ,RARE diseases ,NEONATAL intensive care units ,SUPRAVENTRICULAR tachycardia ,EVALUATION of medical care ,NEONATAL intensive care ,AMIODARONE ,ADRENALINE ,HYDROCORTISONE ,DISCHARGE planning ,HEART conduction system ,HYPOCALCEMIA ,FETAL heart rate ,FLECAINIDE ,HYDROPS fetalis ,ACYCLIC acids ,VITAMIN D ,SYMPTOMS - Abstract
Wolff-Parkinson-White (WPW) syndrome is a rare cardiac condition arising from abnormal embryologic development of the annulus fibrosus in combination with the cardiac conduction system. The abnormality results in the development of accessory pathways and preexcitation changes which can provoke episodes of tachyarrhythmias. The most common presentation of WPW syndrome is supraventricular tachycardia. Beyond customary abortive therapy, chronic management strategies vary based upon timing and clinical severity of the initial disease presentation. Prompt diagnosis and rate control have a dramatic impact on the outcomes of morbidity and mortality. The purpose of this article is to present a case study of a preterm infant who manifested with WPW syndrome. Additionally, the article will explore the pathophysiology of WPW syndrome and the timing and presentation of common clinical manifestations of the disease, along with current diagnostic and treatment strategies to achieve optimal patient outcomes in the neonatal population. [ABSTRACT FROM AUTHOR]
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- 2024
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16. A case of Williams syndrome with Wolff–Parkinson–White syndrome.
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Karadeniz, Cem, Yıldız, Kaan, Öksüz, Sedef, Keçici, Rüveyda Nur, and Çoğulu, Özgür
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Introduction: Williams syndrome (WS) cases have been reported to have with 25–100 times greater increased risk of sudden cardiac death (SCD). SCD has been reported in cases without any evidence of structural cardiovascular anomalies. Wolff–Parkinson–White (WPW) syndrome is characterized by short PR interval and delta wave. Ventricular preexcitations can develop paroxysmal reentrant tachycardia through Kent bundle or less frequent atrial fibrillation and in some cases with accessory pathway effective refractory period (APERP) under 250 ms considered as risky and may lead to SCD. WS associated with WPW has not been reported before. Case Report: An 11‐year‐old male who had been followed up with WS was referred to pediatric cardiology outpatient clinic with the complaint of palpitation. Electrocardiographic examination showed short PR interval and delta wave in the ECG consistent with WPW. He underwent electrophysiological study (EPS). Basic measurements were performed, and APERP was found at 280 ms cycle atrial pacing. RF energy was delivered using a 4 mm tip nonirrigated radiofrequency (RF) ablation catheter where the best ventriculoatrial (VA) signals were received and the AP was abolished within few seconds. Discussion and Conclusions: Although, WPW cases are usually asymptomatic or related to SVT, the risk of SCD should not be ignored. Thus, all patients with WPW deserve an EPS for assessing the AP conduction properties. Due to the increased risk of SCD in patients with WS compared to general population, in the presence of concomitant WPW, these patients should be evaluated with EPS even if they do not have symptoms. [ABSTRACT FROM AUTHOR]
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- 2024
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17. Accessory pathway localization with probabilistic density maps generated by a mobile application: Assessment of a full pre‐excitation net‐vector method.
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Jastrzębski, Marek, Fijorek, Kamil, Futyma, Piotr, Orczykowski, Michał, Pitak, Maciej, Zarębski, Łukasz, Sajdak, Piotr, Góreczny, Sebastian, Szumowski, Łukasz, Rajzer, Marek, and Moskal, Paweł
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WORLD Wide Web , *MOBILE apps , *DATABASE management , *RESEARCH funding , *BODY surface mapping , *PROBABILITY theory , *ARTIFICIAL implants , *HEART conduction system , *ELECTROCARDIOGRAPHY , *APPLICATION software , *DIGITAL image processing , *AUTOMATION , *ELECTROPHYSIOLOGY , *ELECTRODES - Abstract
Introduction: Precise electrocardiographic localization of accessory pathways (AP) can be challenging. Seminal AP localization studies were limited by complexity of algorithms and sample size. We aimed to create a nonalgorithmic method for AP localization based on color‐coded maps of AP distribution generated by a web‐based application. Methods: APs were categorized into 19 regions/types based on invasive electrophysiologic mapping. Preexcited QRS complexes were categorized into 6 types based on polarity and notch/slur. For each QRS type in each lead the distribution of APs was visualized on a gradient map. The principle of common set was used to combine the single lead maps to create the distribution map for AP with any combination of QRS types in several leads. For the validation phase, a separate cohort of APs was obtained. Results: A total of 800 patients with overt APs were studied. The application used the exploratory data set of 553 consecutive APs and the corresponding QRS complexes to generate AP localization maps for any possible combination of QRS types in 12 leads. Optimized approach (on average 3 steps) for evaluation of preexcited electrcardiogram was developed. The area of maximum probability of AP localization was pinpointed by providing the QRS type for the subsequent leads. The exploratory data set was validated with the separate cohort of APs (n = 256); p =.23 for difference in AP distribution. Conclusions: In the largest data set of APs to‐date, a novel probabilistic and semi‐automatic approach to electrocardiographic localization of APs was highly predictive for anatomic localization. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Safety of same-day discharge without anticoagulation for left-sided radiofrequency catheter ablations in pediatrics.
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Palmieri, Vincent, Yijin, Xiang, Fischbach, Peter, and Whitehill, Robert
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For left-sided radiofrequency catheter ablation (LCA) in pediatrics, significant practice variability exists regarding anticoagulation and discharge practices. Given the lack of data in pediatric patients, the risks and benefits of these practices are not well defined. The purpose of this study was to evaluate the safety of same-day discharge and use of aspirin (ASA) in pediatric patients following LCA. We performed a retrospective cohort study of pediatric patients who underwent LCA from 2010 to 2020 at our institution. Discharge timing and ASA usage were based on operator preference. The primary outcome was incidence of postablation anticoagulation complications reported within 1 month of the procedure. Three hundred seventy-six patients underwent LCA and met inclusion criteria. Median [25th, 75th percentiles] age was 13.9 [10.5, 16.2] years; 18 (4.7%) had a history of structural heart disease. The most common substrates for ablation were Wolff-Parkinson-White syndrome (183 patients [48.7%]), concealed accessory pathway (159 patients [42.3%]), and ectopic atrial tachycardia (10 patients [2.7%]). Three hundred thirty-eight patients (89.9%) were discharged on the day of LCA. Seventy-six patients (20.2%) were prescribed ASA at discharge. Of those who underwent follow-up (273 patients [72.6%]), 7 (2.7%) reported an anticoagulation complication (5 with hematoma, 2 with headache). One of these patients was prescribed ASA; none required readmission. There was no correlation between anticoagulation complications and same-day discharge or with ASA usage. Given the rare incidence of anticoagulation complications in pediatric patients undergoing LCAs, same-day discharge from the electrophysiology laboratory without anticoagulation should be considered. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Case Report: Focal cryoablation vs. radiofrequency ablation in a pediatric patient with para-Hisian accessory pathway with effect from the non-coronary aortic cusp
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Zhandos Maksut, Raushan Zhanbolatkyzy, Abay Bakytzhanuly, Almira Bajgalkanova, Yakup Ergül, and Omirbek Nuralinov
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case report ,non-coronary cusp ,Wolff–Parkinson–White syndrome ,radiofrequency ablation ,anteroseptal accessory pathway ,para-Hisian accessory pathway ,Pediatrics ,RJ1-570 - Abstract
A 12-lead electrocardiogram of a pediatric patient with Wolff–Parkinson–White syndrome was consistent with the anteroseptal accessory pathway. The patient had three ablation procedures because of the recurrences of the arrhythmia. In our case, successful cryoablation was performed in the non-coronary cusp of the aortic root.
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- 2024
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20. What is the mechanism of this narrow QRS tachycardia in a patient with type‐A Wolff‐Parkinson‐White (WPW) syndrome?
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Saito, Yuji, Nagashima, Koichi, Wakamatsu, Yuji, Hirata, Shu, Watanabe, Ryuta, Otsuka, Naoto, Hirata, Moyuru, Sawada, Masanaru, Kurokawa, Sayaka, and Okumura, Yasuo
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SUPRAVENTRICULAR tachycardia , *WOLFF-Parkinson-White syndrome , *RIGHT heart atrium , *HIS bundle , *ATRIOVENTRICULAR node , *ARRHYTHMIA - Abstract
This article discusses the mechanism of a narrow QRS tachycardia in a patient with type-A Wolff-Parkinson-White (WPW) syndrome. The patient, a 52-year-old woman, was referred for catheter ablation of the tachycardia. The article presents the case presentation, differential diagnoses, and the final diagnosis of orthodromic reciprocating tachycardia (ORT) via a posteroseptal accessory pathway (AP) with a bystander left lateral AP. The article also explores the clinical insights gained from the case and discusses the challenges in distinguishing between an atrioventricular AP and a nodoventricular pathway. [Extracted from the article]
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- 2024
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21. Editorial: Pharmacological therapy in patients with arrhythmias.
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Sciarra, L., Romano, S., Paparella, G., and Scarà, A.
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WOLFF-Parkinson-White syndrome ,PATIENT compliance ,ATRIAL arrhythmias ,ATRIAL fibrillation ,HEART diseases ,ARRHYTHMIA ,ATRIAL flutter - Abstract
This article is an editorial that discusses the use of pharmacological therapy in patients with arrhythmias. It provides information on the prevalence and incidence of different types of arrhythmias, such as supraventricular tachycardia and atrial fibrillation, and their associated risk factors. The article emphasizes the importance of early detection and maintenance of sinus rhythm in patients with atrial fibrillation. It also discusses the use of catheter ablation and additional pharmacological therapy in managing arrhythmias. The article concludes by mentioning the importance of anticoagulation therapy and the potential benefits of direct-acting oral anticoagulants in certain patient populations. The given document is a list of references for various research articles related to heart disease, stroke, and atrial fibrillation. These articles cover topics such as the epidemiology of atrial fibrillation, predictors of specific types of atrial fibrillation, the impact of ablation on mortality, remote monitoring systems for implantable cardiac defibrillators, and the use of artificial intelligence in the treatment of atrial fibrillation. These articles provide valuable information for library patrons conducting research on these specific topics. [Extracted from the article]
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- 2024
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22. Cryotherapy Versus Radiofrequency Ablation for Treatment of Para-hisian Accessory Pathways
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InCor Heart Institute and Mauricio Ibrahim Scanavacca, Arrhythmia Unit Director - Heart Institute (InCor), MD, PhD
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- 2023
23. Pre-Excited Atrial Fibrillation in Wolff-Parkinson-White (WPW) Syndrome: A Case Report and a Review of the Literature.
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Schiavone, Marco, Filtz, Annalisa, Gasperetti, Alessio, Xiaodong Zhang, Forleo, Giovanni B., Santangeli, Pasquale, and Di Biase, Luigi
- Abstract
Wolff-Parkinson-White (WPW) syndrome is defined by specific electrocardiogram (ECG) changes resulting in ventricular pre-excitation (the so-called WPW pattern), related to the presence of an accessory pathway (AP), combined with recurrent tachyarrhythmias. WPW syndrome is characterized by different supraventricular tachyarrhythmias (SVT), including atrioventricular re-entry tachycardia (AVRT) and atrial fibrillation (AF) with rapid ventricular response, with AVRT being the most common arrhythmia associated with WPW, and AF occurring in up to 50% of patients with WPW. Several mechanisms might be responsible for AF development in the WPW syndrome, and a proper electrocardiographic interpretation is of pivotal importance since misdiagnosing pre-excited AF could lead to the administration of incorrect treatment, potentially inducing ventricular fibrillation (VF). Great awareness of pre-excited AF’s common ECG characteristics as well as associated causes and its treatment is needed to increase diagnostic performance and improve patients’ outcomes. In the present review, starting from a paradigmatic case, we discuss the characteristics of pre-excited AF in the emergency department and its management, focusing on the most common ECG abnormalities, pharmacological and invasive treatment of this rhythm disorder. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Infarto agudo de miocardio después de la ablación por radiofrecuencia en un paciente con síndrome de Wolff-Parkinson-White. A propósito de un caso clínico.
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Taffarel, Pedro, Vallone, Karina, and Maldonadob, Sebastián
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THERAPEUTIC use of nitroglycerin ,LEFT heart ventricle ,ANTICOAGULANTS ,WOLFF-Parkinson-White syndrome ,HEPARIN ,ASPIRIN ,HEART physiology ,ANGIOGRAPHY ,MOVEMENT disorders ,ELECTROCARDIOGRAPHY ,INTENSIVE care units ,ADRENERGIC beta blockers ,CATHETER ablation ,ST elevation myocardial infarction ,DISEASE complications - Abstract
Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
25. Wide QRS tachycardia: What is the mechanism?
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Umapathi, Krishna Kishore, Nayak, Hemal M., and Kohli, Utkarsh
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- *
WOLFF-Parkinson-White syndrome , *CHEST pain , *ELECTROCARDIOGRAPHY , *TACHYCARDIA - Abstract
The article presents the discussion on case study of 17-year-old healthy male with chest pain and intermittent episodes of shortness of breath. Topics include risk stratification and possible catheter ablation of AP due to the small but well-characterized risk of sudden death associated with asymptomatic pre-excitation; and ongenitally corrected transposition of the great arteries, and hypertrophic cardiomyopathy appears to confer a higher risk of multiple APs.
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- 2024
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26. Geschichte der chirurgischen Behandlung von Herzrhythmusstörungen in Deutschland: Chirurgische Therapie ventrikulärer Tachykardien sowie supraventrikulärer Tachykardien, insbesondere Präexzitationssyndromen (WPW).
- Author
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Klein, Helmut U., Trappe, Hans-Joachim, and Frank, Günter
- Abstract
Copyright of Herzschrittmachertherapie und Elektrophysiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
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27. Kurze Geschichte der Katheterablation mit DC-Schocks.
- Author
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Klein, Helmut U., Trappe, Hans-Joachim, and Frank, Günter
- Abstract
Copyright of Herzschrittmachertherapie und Elektrophysiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
- Full Text
- View/download PDF
28. Historische Entwicklung in Diagnostik und Therapie bei Präexzitationssyndromen (WPW).
- Author
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Rudic, Boris and Borggrefe, Martin
- Abstract
Copyright of Herzschrittmachertherapie und Elektrophysiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
- Full Text
- View/download PDF
29. Long QT Syndrome and WPW Syndrome: A Very Rare Association between Two Causes of Sudden Cardiac Death in a Young Patient.
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Vătășescu, Radu Gabriel, Deaconu, Silvia, Iorgulescu, Corneliu Nicolae, Marascu, Gabriela, Oprita, Bogdan, and Deaconu, Alexandru
- Subjects
- *
WOLFF-Parkinson-White syndrome , *BRUGADA syndrome , *CARDIAC arrest , *LONG QT syndrome , *IMPLANTABLE cardioverter-defibrillators - Abstract
Long QT syndrome (LQT) and WPW syndrome are causes of sudden cardiac death (SCD) in the young, and their association has been rarely reported. A 26-year-old woman presented with recurrent syncope. Her ECG showed a short PR interval, wide QRS (150 ms) due to a delta wave, and QT prolongation (QT 580 ms, QTc 648 ms). ECG monitoring documented recurrent salvos of a self-terminating wide QRS tachycardia, generally slightly polymorphic, sometimes with "torsade des pointes" (TdP) appearance, which were linked to the syncopal/presyncope episodes. Electrophysiologic monitoring diagnosed a right para-hisian accessory pathway with a very short ERP (240 ms baseline, <200 ms after isoproterenol). The pathway was ablated successfully. Despite QRS narrowing (80 ms), QT prolongation persisted after ablation (QT 620 ms, QTc 654 ms), with short runs of TdP, despite beta-blocker treatment, which was increased to the maximal dosage. A dual-chamber implantable cardioverter defibrillator (ICD) was implanted. To our knowledge, this is the first case report of an association between LQT and WPW syndrome in which both conditions are associated with an increased risk of SCD. [ABSTRACT FROM AUTHOR]
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- 2024
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30. Wolf–Parkinson–White Syndrome: Diagnosis, Risk Assessment, and Therapy—An Update.
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Vătășescu, Radu Gabriel, Paja, Cosmina Steliana, Șuș, Ioana, Cainap, Simona, Moisa, Ștefana María, and Cinteză, Eliza Elena
- Subjects
- *
ARRHYTHMIA , *WOLFF-Parkinson-White syndrome , *BRUGADA syndrome , *CONGENITAL heart disease , *CARDIAC arrest , *RISK assessment , *DIAGNOSIS - Abstract
Wolf–Parkinson–White (WPW) syndrome is a disorder characterized by the presence of at least one accessory pathway (AP) that can predispose people to atrial/ventricular tachyarrhythmias and even sudden cardiac death. It is the second most common cause of paroxysmal supraventricular tachycardia in most parts of the world, affecting about 0.1–0.3% of the general population. Most patients with WPW syndrome have normal anatomy, but it may be associated with concomitant congenital heart disease or systemic diseases. Although many individuals are asymptomatic, during supraventricular arrhythmia episodes, they may experience severe symptoms, including syncope or even sudden cardiac death (mainly due to pre-excited atrial fibrillation over rapidly conducting AP). In addition to arrhythmia-related symptoms, for some specific locations of the APs with overt anterograde conduction, there might be a reduction in exercise capacity mediated by a reduction in LV systolic performance due to anomalous LV depolarization. Although it is typically diagnosed through electrocardiography (ECG), additional tests are necessary for risk assessment. Management of WPW syndrome may be quite challenging and can vary from only acknowledging the presence of the accessory pathway to pharmacological treatment or radiofrequency ablation. Early diagnosis, risk assessment, and appropriate treatment are critical steps in the management of WPW syndrome, aiming to improve the quality of life and reduce the risk of life-threatening arrhythmias. [ABSTRACT FROM AUTHOR]
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- 2024
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31. The Incidence and Factors Associated with the Recurrence of Supraventricular Tachycardia in Children: 15 Years Experience from Middle-Income Country.
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Bah, Mohd Nizam Mat, Zahari, Norazah, Boparam, Baljit Kaur, and Sapian, Mohd Hanafi
- Subjects
- *
SUPRAVENTRICULAR tachycardia , *WOLFF-Parkinson-White syndrome , *MIDDLE-income countries , *REGRESSION analysis - Abstract
Limited data are available concerning supraventricular tachycardia (SVT) recurrence. Hence, this study aimed to determine the incidence, outcome, and factors associated with SVT recurrence. This retrospective, observational, population-based study was conducted among children with SVT from 2006 to 2020. The primary outcome measure was SVT recurrence. Kaplan Meier analysis was used to estimate SVT-free at 1, 5, and 10 years after diagnosis. Cox regression analysis was used to identify independent factors associated with recurrence. There were 156 patients with SVT with a median age at diagnosis of 1.9 years (Interquartile range [IQR] 11 days to 8.7 years) and follow-up for a median of 3.5 years (IQR 1.7 to 6.1 years). 35 patients (22%) had recurrent SVT at a median age of 7.8 years (IQR 4.4 to 12 years). Infants with Wolff-Parkinson-White Syndrome (WPW) had the highest recurrence (11/16, 68%), with 33% SVT-free at 5 years follow-up. The lowest recurrence rate was observed in neonatal diagnosis (2/54, 3.7%) with 98% SVT-free at 5 years follow-up. The independent factors associated with the recurrence of SVT were the diagnosis of WPW with an adjusted hazard ratio (aHR) of 5.2 (95% CI 2.4–11.2), age of more than 1 year at diagnosis (aHR 3.7 95% CI 1.4–9.7), and combine with or need second-line therapy (aHR 4.0 95% CI 1.5–10.7). One in five children with SVT experienced a recurrence, which is more likely for those with WPW, multiple maintenance therapy, and older age at first presentation. Whereas neonates with non-WPW may benefit from shorter maintenance therapy. [ABSTRACT FROM AUTHOR]
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- 2024
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32. Risk assessment in patients with symptomatic and asymptomatic pre-excitation.
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Jemtrén, Anette, Saygi, Serkan, Åkerström, Finn, Asaad, Fahd, Bourke, Tara, Braunschweig, Frieder, Carnlöf, Carina, Drca, Nikola, Insulander, Per, Kennebäck, Göran, Nordin, Astrid Paul, Sadigh, Bita, Rickenlund, Anette, Saluveer, Ott, Schwieler, Jonas, Svennberg, Emma, Tapanainen, Jari, Turkmen, Yusuf, Bastani, Hamid, and Jensen-Urstad, Mats
- Abstract
Aims Controversy remains as to whether the exercise stress test (EST) is sufficient for risk evaluation in patients with pre-excitation. This study aims to clarify the usefulness of EST in risk stratification in both asymptomatic and symptomatic patients presenting with pre-excitation. Methods and results This prospective study includes consecutive asymptomatic and symptomatic patients with pre-excitation referred for risk assessment. All participants performed an incremental EST (bicycle) prior to an electrophysiology study (EPS). Primary data from the EST included loss of pre-excitation during exercise, and primary data from the EPS included the measurement of accessory pathway effective refractory period (APERP), shortest pre-excited RR interval (SPERRI), and inducible arrhythmia with the use of a beta-adrenergic receptor agonist if deemed necessary. One hundred and sixty-four patients (59 asymptomatic, 105 symptomatic) completed an EST and EPS. Forty-five patients (27%) demonstrated low-risk findings on EST, of which 19 were asymptomatic and 26 were symptomatic. Six patients with low-risk EST findings had SPERRI/APERP ≤ 250 ms at EPS, and two of them were asymptomatic. The sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy of low-risk EST for excluding patients with SPERRI/APERP ≤ 250 ms were 40, 91, 87, 51, and 60%, respectively. The number of patients with inducible arrhythmia at EPS was similar in the asymptomatic (36, 69%) and symptomatic (73, 61%) groups. Conclusion Sudden loss of pre-excitation during EST has a low NPV in excluding high-risk APs. The EPS with the use of isoproterenol should be considered to accurately assess the risk of patients with pre-excitation regardless of symptoms (ClinicalTrials.gov Identifier: NCT03301935). [ABSTRACT FROM AUTHOR]
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- 2024
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33. PRKAG2 syndrome, a rare hypertrophic cardiomyopathy: a Brazilian long-term follow-up with extracardiac disorders
- Author
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Lenises de Paula van der Steld, Mario de Seixas Rocha, Ana Marice Teixeira Ladeia, Humberto Lago Livramento, Gervásio Batista Campos, Francisco Carlos da Costa Darrieux, Oscar Campuzano, and Ramon Brugada
- Subjects
Mutation hypertrophy ,Left ventricle ,Wolff-Parkinson-White syndrome ,Death ,Sudden cardiac ,Activated protein kinases/genetics ,Medicine - Abstract
ABSTRACT Objective This study aimed to provide a long-term follow-up of PRKAG2 syndrome and describe the new phenotypic aspects of the condition. PRKAG2 syndrome is a rare autosomal-dominant glycogen storage disease characterized by cardiac hypertrophy, ventricular pre-excitation, and conduction system disease. Fatal arrhythmias occur frequently. Methods A family cohort of 66 participants was recruited. Clinical and genetic analyses were performed. Results Median age of 36.97±17.28 years, with 69.9% being men. Nineteen subjects carried the deleterious variant p.K290I of the PRKAG2 gene. This group experienced many malignant events, including eight pacemaker implants, three sudden cardiac deaths, five aborted cardiac arrests, four strokes, four premature neonatal deaths, two spontaneous abortions, five forceps deliveries, and 12 cesarean procedures. Extracardiac involvement, such as in neurocognitive and psychiatric disorders, has been observed only in carriers of mutations. Palpitations, Syncope, atrial fibrillation, atrial flutter, sinus pauses, and bradycardia were strongly and significantly associated with major or severe adverse events (sudden cardiac death, aborted cardiac arrest, pacemaker use, stroke, and congestive heart failure). Early diagnosis and intervention through antiarrhythmic drugs, anticoagulation, pacemaker implantation, radiofrequency catheter ablation, and cesarean section surgery improved the symptoms and survival rates. Mutations carriers were advised to avoid pregnancy. Conclusion This study identified that the p.K291I_PRKAG2 mutation is associated with poor prognosis, highlighting the need for early intervention. Further research may uncover the potential connections between intellectual disability, miscarriage, and neonatal death in individuals with this syndrome.
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- 2024
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34. Dual challenge inside the womb: a case report of concomitant fetal atrio-ventricular block associated with maternal anti-SSA antibodies and fetal tachyarrhythmia diagnosed as Wolff-Parkinson-White syndrome after birth
- Author
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Ana Teodósio Chícharo, Mónica Rebelo, Ana Rita Lopes, Maria João Saavedra, Maria Filipa Paramés, Ana Rita Araújo, Ana Rita Cruz-Machado, Luísa Pinto, and Susana Capela
- Subjects
case report ,fetal atrio-ventricular block ,congenital heart block ,Wolff-Parkinson-White syndrome ,pregnancy ,anti-SSA/Ro antibodies ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Fetal autoimmune atrioventricular block (AVB) is a rare but potentially life-threatening condition. It results from the passage of maternal anti-SSA/Ro or Anti SSB/La auto-antibodies into the fetal circulation, leading to inflammation and fibrosis of the AV node and often to irreversible damage. Besides AVB, these antibodies can also cause cardiomyopathies, but there is no evidence linking them to tachyarrhythmias. We present the case of a patient with significant risk factors for fetal AVB: a prior history of hydrops fetalis, high anti-SSA/Ro antibody levels and hypothyroidism. In this case, the use of dexamethasone and intravenous immunoglobulin may have contributed to reversing the first-degree atrioventricular block detected at 19 weeks of gestation. Additionally, at 21 weeks, the fetus developed a tachyarrhythmia that needed treatment with flecainide. Soon after the birth, the newborn underwent ECG Holter and Wolff-Parkinson-White Syndrome (WPWS) was diagnosed. To our knowledge, the coexistence of fetal AVB and WPWS has never been described.
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- 2024
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35. Nursing Continuing Professional Development Activities: July/August 2024.
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PEDIATRIC nurses ,CONTINUING education units ,WOLFF-Parkinson-White syndrome ,INFANT care ,BOTTLE feeding ,PROFESSIONAL employee training ,ARTIFICIAL respiration ,PREECLAMPSIA ,NEONATAL nursing ,CONTINUING education - Published
- 2024
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36. Is this an anteroseptal accessory pathway?
- Author
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Zhu, Bin, Zeng, Lijun, Wang, Qin, and Pu, Xiaobo
- Abstract
The ECG of a patient during sinus rhythm shows preexcited QRS pattern, with rS pattern in lead V1, transition in lead V2, and positive inferior leads. Following the stepwise algorithms, the location of accessory pathway (AP) was identified at anteroseptal region. However, the precordial transition in lead V2 indicates mid-septal or posteroseptal AP. The mismatch suggested multiple APs and 5 APs were identified by electrophysiologic study. This case highlights the importance of detailed analysis of ECG in order to achieve adequate ablation. [ABSTRACT FROM AUTHOR]
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- 2024
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37. Treatment of Infantile Hemangiomas in Concomitant Tuberous Sclerosis Complex Should Prompt Evaluation for Cardiac Rhabdomyomas Prior to Initiation of Propranolol.
- Author
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Buethe, Maria Gnarra, Di Franco, Antonino, Uwakwe, Laura, and Glick, Sharon A.
- Subjects
TUBEROUS sclerosis ,PROPRANOLOL ,HEMANGIOMAS ,ARRHYTHMIA ,HAMARTOMA ,MEDICAL communication ,WOLFF-Parkinson-White syndrome - Abstract
This article discusses the importance of evaluating for cardiac rhabdomyomas in patients with infantile hemangiomas (IH) and tuberous sclerosis complex (TSC) before initiating treatment with propranolol. The case study presented describes a patient with IH and hypopigmented macules who was found to have multiple cardiac rhabdomyomas in the context of TSC. The article emphasizes the need for dermatologists to be familiar with TSC diagnostic criteria in order to make appropriate referrals for further evaluation. Cardiology screening is necessary in patients with TSC to rule out rhabdomyomas with associated arrhythmias or obstructed blood flow before starting treatment. [Extracted from the article]
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- 2024
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38. Left Ventricular Hypertrophy With Preexcitation.
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Mahesh, Maithree, Mantoo, Mohsin Raj, and Makkar, Nayani
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- *
HEART failure , *LEFT ventricular hypertrophy , *MEDICAL sciences , *CARDIAC magnetic resonance imaging , *WOLFF-Parkinson-White syndrome - Abstract
This article discusses a case of a 16-year-old boy with left ventricular hypertrophy (LVH) and preexcitation on an electrocardiogram (ECG). The boy presented with symptoms of shortness of breath and swelling of the feet, and further examination revealed LVH and severe impairment of the left ventricular ejection fraction. The presence of preexcitation in a background of LVH may indicate underlying conditions such as Danon disease, PRKAG2 mutation cardiomyopathy, Fabry disease, Pompe disease, or mitochondrial disorders. In this case, the patient was diagnosed with Danon disease, a rare X-linked disorder characterized by cardiomyopathy, skeletal myopathy, and intellectual disability. The article emphasizes the importance of careful interpretation of ECG findings and the need for clinical correlation and genetic testing to determine the underlying cause of heart failure. [Extracted from the article]
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- 2024
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39. وجود راه فرعی دهلیزی بطنی میتواند باعث نارسایی قلبی به علت اختلال توالی دیولاریزاسیون قلبی شود گزارش یک مورد.
- Author
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بابک پیامی, شیرین عزیزی دوست, and نعیم منصوری
- Abstract
Background: Wolff-Parkinson-White syndrome is a rare but well-known disease that predisposes a person to cardiac arrhythmias. But sometimes this syndrome is accompanied by heart failure in the affected person. Several causes have been proposed for this complication including recurrent or incessant tachyarrhythmias that are frequently found in symptomatic (especially children) Wolf-Parkinson-White syndrome patients causing heart dysfunction and dilation and dilated cardiomyopathy, and also pre-excitation-related dyssynchrony leading to progressive ventricular remodeling and dilation. In this report, a patient is introduced who has improved his heart failure by radio-frequency ablation of free wall type of this syndrome. Case Presentation: A 35-year-old man who had a history of Wolff-Parkinson-White syndrome from 8 years ago and suffered from dilatation and reduced left ventricular ejection fraction in recent years was presented with a pre-excited atrial fibrillation attack at the emergency department. The initial surface ECG showed positive delta wave in all precordial leads and negative QRS complexes in interior leads with QRS duration of about 200 ms. He had undergone electrophysiology study and ablation at the left postero-lateral accessory pathway. After ablation of accessory pathway within the months (from November 2022 until June 2023), left ventricular function was gradually improved and the symptoms of the patient's shortness of breath were also decreased. Conclusion: The existence of heart failure in patients with Wolff-Parkinson-White syndrome can be due to various reasons including the presence of an accessory pathway and the dyssynchrony of intraventricular contraction which is caused by premature excitation of the connected part of the left ventricle by accessory atrioventricular pathway. Although in order to rule out the possibility of the incidental association of the accessory pathway with primary dilated cardiomyopathy and to investigate the segmental dyskinesia, it is necessary to perform diagnostic measures such as echocardiography and cardiac computerized tomography and magnetic resonance imaging, ablation of such accessory pathway not only controls arrhythmic attacks but also leads to the improvement of the left ventricular systolic function even in a middle age patient. [ABSTRACT FROM AUTHOR]
- Published
- 2024
40. Surgery for Cardiac Arrhythmias: Past, Present, Future.
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Waterford, Stephen D. and Ad, Niv
- Subjects
- *
ARRHYTHMIA , *WOLFF-Parkinson-White syndrome , *CARDIAC surgery , *ATRIAL fibrillation , *VENTRICULAR tachycardia - Abstract
There is a rich history of surgery for cardiac arrhythmias, spanning from atrial fibrillation and Wolff–Parkinson–White syndrome to inappropriate sinus tachycardia and ventricular tachycardia. This review describes the history of these operations, their evolution over time, and the current state of practice. We devote considerable time to the discussion of atrial fibrillation, the most common cardiac arrhythmia addressed by surgeons. We discuss ablation of atrial fibrillation as a stand-alone operation and as a concomitant operation performed at the time of cardiac surgery. We also discuss the emergence of newer procedures to address atrial fibrillation in the past decade, such as the convergent procedure and totally thoracoscopic ablation, and their outcomes relative to historic approaches such as the Cox maze procedure. [ABSTRACT FROM AUTHOR]
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- 2024
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41. The appearance of new accessory pathway after the Cone procedure.
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Nguyen, Dinh Son Ngoc, Chang, Shih‐Lin, Weng, Chi‐Jen, Wu, Fei‐Yi, and Chen, Shih‐Ann
- Subjects
- *
TACHYCARDIA diagnosis , *WOLFF-Parkinson-White syndrome , *CATHETER ablation , *SURGICAL complications , *PLASTIC surgery , *SUPRAVENTRICULAR tachycardia , *ELECTROPHYSIOLOGY , *EBSTEIN'S anomaly , *REOPERATION , *ELECTROCARDIOGRAPHY - Abstract
Introduction: Acquired Wolff–Parkinson–White (WPW) syndrome can occur after congenital heart disease (CHD) surgery. Methods and Results: A 27‐year‐old male with Ebstein's anomaly and manifest WPW syndrome received catheter ablation twice. The first electrophysiology study (EPS) induced orthodromic atrioventricular reentrant tachycardia and successfully eliminated the posteroseptal accessory pathway (AP). Six months after the Cone procedure, the patient suffered from palpitation. The second EPS was performed and abolished the right lateral AP. Conclusion: The appearance of a new AP after the reconstruction of CHD is a rare finding and should raise suspicion of an acquired AP connection. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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42. Open‐window mapping for ablation of Wolff–Parkinson–White syndrome related hemodynamically unstable tachycardia.
- Author
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Kantharia, Bharat K. and Shah, Arti N
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- *
WOLFF-Parkinson-White syndrome treatment , *ATRIOVENTRICULAR node , *PATHOLOGICAL anatomy , *CATHETER ablation , *BODY surface mapping , *SUPRAVENTRICULAR tachycardia , *CARDIAC pacing , *ELECTROCARDIOGRAPHY , *HEMODYNAMICS , *HEART conduction system - Abstract
During catheter ablation (CA) of tachycardia, conventional point‐by‐point mapping may be hindered due to hemodynamic instability. We performed open‐window mapping (CARTO, Biosense Webster, USA) in a patient who developed hemodynamic instability during orthodromic atrioventricular reciprocating tachycardia (AVRT) and unwarranted induction of AVRT during attempts to map accessory pathway (AP) with ventricular pacing. With over 11,000 points acquired rapidly, the system accurately identified AP at the mitral valve (MV) annulus where the application of single radiofrequency (RF) lesion promptly eliminated AP's conduction. Our case illustrates the utility of open‐window mapping for the ablation of AVRT. [ABSTRACT FROM AUTHOR]
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- 2023
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43. Langzeitergebnisse der Katheterablation bei AV-Knoten-Reentry-Tachykardien und akzessorischen Leitungsbahnen.
- Author
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Alken, Fares-Alexander, Scherschel, Katharina, Zhu, Ernan, Kahle, Ann-Kathrin, and Meyer, Christian
- Abstract
Copyright of Herzschrittmachertherapie und Elektrophysiologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
- Full Text
- View/download PDF
44. Antidromic and orthodromic reciprocating tachycardias over a novel left‐sided accessory pathway involving the vein of Marshall and coronary sinus musculature.
- Author
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Kanzaki, Yasunori, Morishima, Itsuro, Miyazawa, Hiroyuki, and Shimojo, Kazuki
- Subjects
- *
WOLFF-Parkinson-White syndrome , *PATHOLOGICAL anatomy , *CATHETER ablation , *SUPRAVENTRICULAR tachycardia , *TREATMENT effectiveness , *ELECTROCARDIOGRAPHY , *CORONARY arteries - Abstract
Introduction: Herein, we present a rare case of the successful ablation of an accessory pathway (AP) involving the Marshall Bundle (MB) and coronary sinus musculature (CSM) in a 40‐year‐old man with Wolff−Parkinson−White syndrome. Methods and Results: An orthodromic reciprocating tachycardia (ORT) was inducible with the earliest atrial activation site located at the posterolateral mitral annulus. The local conduction and the cycle length of ORT was prolonged by peri‐mitral ablation; however, it failed to block the AP. The atrial insertion of the AP was identified by remapping during ORT at the left atrial ridge, which was away from the mitral annulus, where ablation was successful. Together with the electrophysiological findings in CSM potentials, we conclude that the epicardial MB‐CSM connection functioned as the AP in this patient. Conclusion: The novel variant form of AP comprised of MB and CSM should be noted. The atrial insertion of the MB may be the target of catheter ablation. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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45. Tachycardia in the Emergency Department: Part II.
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- *
ARRHYTHMIA , *ATRIAL flutter , *TACHYCARDIA , *HEART conduction system , *HOSPITAL emergency services , *WOLFF-Parkinson-White syndrome , *VENTRICULAR tachycardia - Abstract
In the presence of a pulmonary embolism (PE), the most common vital sign abnormality is tachycardia.[8] Physiologically, a PE can lead to tachycardia by increasing afterload on the right ventricle, which requires the heart rate to increase to maintain cardiac output. Rahul Rege AUTHOR I Rahul Rege, MD, Assistant Professor of Emergency Medicine, Penn State Health - Milton S. Hershey Medical Center, PA i PEER REVIEWER I B Frank LoVecchio, DO, FACEP, b Vice-Chair for Research, Medical Director, Samaritan Regional Poison Control Center, Emergency Medicine Department, Maricopa Medical Center, Phoenix, AZ i EXECUTIVE SUMMARY In many conditions, sinus tachycardia occurs as a compensatory response to maintain cardiac output and oxygen delivery to vital organs. A unique aspect of management of the tachycardic patient is determining whether the tachycardia is caused by underlying illness or whether the tachycardia is a result of the primary tachydysrhythmia. In the correct clinical setting, tests such as a basic metabolic panel, magnesium and phosphorus levels, complete blood count, thyroid studies, troponin, and imaging can aid in determining the underlying cause of a patient's tachycardia. SP 19,20 sp Management Management of patients presenting to the emergency department with tachycardia is centered on using the history, physical examination, and diagnostic approach to guide therapeutics and resuscitation. [Extracted from the article]
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- 2023
46. Iatrogenic cardiomyopathy in patients with manifest right supero‐paraseptal accessory pathways.
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Abdelrahim, Elsheikh, Birchak, John, Khan, Arfaat, and Maskoun, Waddah
- Subjects
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WOLFF-Parkinson-White syndrome , *ATRIOVENTRICULAR node , *CARDIAC catheterization , *ECHOCARDIOGRAPHY , *VENTRICULAR ejection fraction , *LEFT ventricular dysfunction , *CARDIOMYOPATHIES , *BUNDLE-branch block , *IATROGENIC diseases , *CATHETER ablation , *SUPRAVENTRICULAR tachycardia , *TREATMENT effectiveness , *ELECTROPHYSIOLOGY , *HEART block , *HEART conduction system , *ABLATION techniques - Abstract
Introduction: We describe two patients with right supero‐paraseptal accessory pathway (SPAP) who developed left ventricular dysfunction associated with an increased degree of ventricular pre‐excitation and frequent orthodromic reciprocating tachycardia (ORT) due to worsening atrioventricular (AV) node conduction. Methods and Results: Case 1: 48‐year‐old female with a history of normally functioning mechanical mitral valve, CABG, and ventricular pre‐excitation that worsened after her open heart surgery. She presented with frequent palpitations with documented supraventricular tachycardia (SVT) and found to have a new left ventricular dysfunction with decrease in left ventricular ejection fraction (LVEF) from 55% to 46% with dyssynchrony. An electrophysiological study confirmed a right SPAP and ORT. The pathway was successfully ablated from the antegrade approach after careful mapping. After ablation and 6‐month follow up echocardiogram showed improvement of EF to 54% and the LV dyssynchrony resolved. Case 2: 51‐year‐old male with a history of frequent SVT with recent unsuccessful ablations that resulted in worsening ventricular pre‐excitation, more frequent SVT, and new left ventricular dysfunction (LVEF from 60% to 40%). He was started on amiodarone which resulted in significant sinus bradycardia, intermittent ventricular pre‐excitation, and first degree AV block with significant increase in ORT events. His electrophysiology study confirmed SPAP which was successfully ablated from the antegrade approach after careful mapping. After 1 month, follow‐up echocardiogram showed an improved ejection fraction to 60%. Conclusion: Left ventricular dysfunction due to dyssynchrony and symptomatic frequent ORT of right SPAP can develop in the setting of new iatrogenic diminished AV node conduction. Successful ablation will result in LV function recovery to baseline. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
47. Ventricular Preexcitation in Hypertrophic Cardiomyopathy: Dove or a Hawk?
- Author
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Chubb, Henry and Dubin, Anne M.
- Published
- 2023
- Full Text
- View/download PDF
48. An accessory for pathway ablation
- Author
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Jason Tri, Aditi Sriram, and Samuel J. Asirvatham
- Subjects
Ablation ,Cryoablation ,Accessory pathway ,Supraventricular tachycardia ,Wolff-Parkinson-White syndrome ,Ablation failure ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2024
- Full Text
- View/download PDF
49. Risk Assessment in Patients With Symptomatic- and Asymptomatic Preexcitation (RASAP)
- Author
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Mats Jensen-Urstad, Professor
- Published
- 2022
50. Atypical Pre-excitation Pattern in Asymptomatic Wolff-Parkinson-White—A Hallmark for High Risk?
- Author
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Burcin, Alexandru-Paul, Ene, Elena, and Vătăşescu, Radu-Gabriel
- Subjects
- *
WOLFF-Parkinson-White syndrome , *CARDIAC arrest , *MITRAL valve insufficiency , *ASYMPTOMATIC patients - Abstract
Delta wave morphology during sinus rhythm on 12 lead ECG usually allows for a relatively precise prediction of the anatomic location of an accessory pathway (AP) provided that the rhythm is fully pre-excited. However, the pre-excitation pattern during sinus rhythm usually offers little information about sudden cardiac death (SCD) risk in adult patients with asymptomatic Wolf-Parkinson-White (WPW). A 42-year-old policeman was referred for an asymptomatic WPW pattern with an unusual delta wave. Initial mapping showed that atrio-ventricular (A-V) fusion on the lateral mitral annulus and radiofrequency (RF) ablation induced a shift in the pre-excitation pattern. Re-mapping identified A-V fusion on the left postero-septal area. Another RF application eliminated pre-excitation. Re-mapping identified A-V fusion on the postero-septal aspect of the mitral annulus and another RF application almost instantaneously induced an A-V split and loss of pre-excitation. Post-ablation testing proved normal anterograde A-V conduction without pre-excitation and no ventriculo-atrial conduction. Serial ECGs proved the persistent loss of pre-excitation at one-month of follow-up. This case highlights the diagnostic challenges associated with atypical pre-excitation patterns and the importance of a thorough evaluation in asymptomatic individuals. Patients with atypical pre-excitation may harbor multiple accessory pathways (MAPs) and should be carefully assessed to mitigate the risk of SCD. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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