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International Heart Journal Mar 2019A 41-year-old man developed cardiac arrest. A resting 12-lead electrocardiogram showed a delta wave, suggestive of preexcitation syndrome. An electrophysiological test...
A 41-year-old man developed cardiac arrest. A resting 12-lead electrocardiogram showed a delta wave, suggestive of preexcitation syndrome. An electrophysiological test revealed the existence of inducible atrial fibrillation and a fasciculoventricular accessory pathway (FVAP). After these examinations, idiopathic ventricular arrhythmia was suspected. For evaluating concealed Brugada syndrome, pilsicainide was administered, which diminished the delta wave and no Brugada-like electrocardiogram was observed. Ventricular double extra-stimulation from the RV apex easily induced VF, which could not be defibrillated by an external defibrillator, and later stopped spontaneously. These results established the diagnosis of FVAP and idiopathic VF, and not pre-excited atrial fibrillation or Brugada syndrome.
Topics: Accessory Atrioventricular Bundle; Adult; Brugada Syndrome; Death, Sudden, Cardiac; Defibrillators; Diagnosis, Differential; Electric Countershock; Electrocardiography; Electrophysiologic Techniques, Cardiac; Humans; Male; Pre-Excitation Syndromes; Remission, Spontaneous; Treatment Failure; Ventricular Fibrillation
PubMed: 30745545
DOI: 10.1536/ihj.18-546 -
Europace : European Pacing,... Jul 2023Wolff-Parkinson-White (WPW) syndrome is a conduction disorder characterized by an accessory electrical pathway between the atria and ventricles, which may predispose to... (Clinical Trial)
Clinical Trial
AIMS
Wolff-Parkinson-White (WPW) syndrome is a conduction disorder characterized by an accessory electrical pathway between the atria and ventricles, which may predispose to supraventricular tachycardia (SVT) and sudden cardiac death. It can be seen as an isolated finding or associated with structural heart disease. Our aims were to determine the prevalence of a WPW pattern in a large and unselected cohort of neonates and to describe the electro- and echocardiographic characteristics as well as the natural history during early childhood.
METHODS AND RESULTS
Electrocardiograms and echocardiograms of neonates (aged 0-30 days) from a large, prospective, population-based cohort study were included. Neonates with a WPW pattern were identified and matched 1:4 to controls. Localization of the accessory pathway was assessed by different algorithms. Among 17 489 neonates, we identified 17 (76% boys) with a WPW pattern consistent with a prevalence of 0.1%. One neonate had moderate mitral regurgitation while other echocardiographic parameters were similar between cases and controls (all P > 0.05). The accessory pathways were primarily predicted to be left-sided. At follow-up (available in 14/17 children; mean age 3.2 years) the pre-excitation pattern persisted in only four of the children and none of the children had experienced any episodes of SVT.
CONCLUSION
The prevalence of a WPW pattern in our cohort of unselected neonates was 0.1%. The WPW pattern was more frequent in boys and generally not associated with structural heart disease, and the accessory pathways were primarily left-sided. At follow-up, the WPW pattern had disappeared in most of the children suggesting either an intermittent nature or that normalization occurs.
CLINICAL TRIAL REGISTRATION
Copenhagen Baby Heart, NCT02753348.
Topics: Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Accessory Atrioventricular Bundle; Cohort Studies; Electrocardiography; Heart Diseases; Prospective Studies; Tachycardia, Supraventricular; Wolff-Parkinson-White Syndrome
PubMed: 37465966
DOI: 10.1093/europace/euad165 -
Developmental Period Medicine 2018Essentially, preexcitation syndrome is the presence of an accessory pathway in the heart, which can lead to serious consequences, ranging from atrioventricular reentrant...
INTRODUCTION
Essentially, preexcitation syndrome is the presence of an accessory pathway in the heart, which can lead to serious consequences, ranging from atrioventricular reentrant tachycardia to sudden cardiac death. Wolff-Parkinson-White syndrome is the most common preexcitation syndrome.
AIM OF THE STUDY
The aim of the study was to evaluate the clinical course of the disease, as well as the treatment of children and adolescents hospitalized in the Department of Pediatric Cardiology in the years 2008-2015.
MATERIALS AND METHODS
The study was carried out in 45 children (62 % male, 38% female; the mean age 11 years). During the study we analyzed 12-lead ECG, 24-hour Holter ECG, echocardiography and the cycloergometric exercise test. The results of treatment were also discussed.
RESULTS
Apart from the typical features of preexcitation, the most prevalent abnormality found in ECG was atrioventricular reentrant tachycardia. In 24-hour Holter ECG the most frequently detected disorders were premature ventricular beats and premature atrial contractions. Structural heart defects were detected in 8.9% of the children. The cycloergometric exercise test was positive in 8.9% of patients. The mean duration of symptoms before the diagnosis was 2.5 years. 25% of the patients were asymptomatic. 42.2% of the children needed antiarrhythmic therapy, while 44.4% had accessory pathways ablated.
CONCLUSIONS
The most common symptom of preexcitation in the study group were heart palpitations. The most frequent type of arrhythmia in children with preexcitation syndrome was orthodromic atrioventricular reentrant tachycardia. For the majority of older children ablation of the accessory pathway was a recommended form of treatment. In younger children the standard preventive pharmacological treatment was applied for 6 to 12 months.
Topics: Adolescent; Child; Child, Preschool; Electrocardiography; Female; Humans; Infant; Infant, Newborn; Male; Wolff-Parkinson-White Syndrome
PubMed: 30056397
DOI: 10.34763/devperiodmed.20182202.113122 -
Europace : European Pacing,... Aug 2023This review article reflects how publications in EP Europace have contributed to advancing the science of management of arrhythmic disease in children and adult patients... (Review)
Review
This review article reflects how publications in EP Europace have contributed to advancing the science of management of arrhythmic disease in children and adult patients with congenital heart disease within the last 25 years. A special focus is directed to congenital atrioventricular (AV) block, the use of pacemakers, cardiac resynchronization therapy devices, and implantable cardioverter defibrillators in the young with and without congenital heart disease, Wolff-Parkinson-White syndrome, mapping and ablation technology, and understanding of cardiac genomics to untangle arrhythmic sudden death in the young.
Topics: Adult; Humans; Child; Heart Defects, Congenital; Heart; Wolff-Parkinson-White Syndrome; Cardiac Resynchronization Therapy Devices; Death, Sudden
PubMed: 37622573
DOI: 10.1093/europace/euad155 -
Cureus Oct 2023Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac preexcitation syndrome that arises from abnormal cardiac electrical conduction through an accessory pathway... (Review)
Review
Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac preexcitation syndrome that arises from abnormal cardiac electrical conduction through an accessory pathway and results in symptomatic and life-threatening arrhythmias. The aim of this study is to analyze the patterns of gender representation among first-author publications concerning "Wolf-Parkinson-White syndrome" within the PubMed-indexed publications from "January 1, 1973, to December 31, 2022," based on country and year. On May 9, 2023, bibliometric analysis was performed. The phrase "(Wolf-Parkinson-White Syndrome)" was looked up in PubMed. It covered articles released between January 1, 1973, and December 31, 2022. Articles accepted in the year 2022 and published in Pubmed in 2023 were included in the study. A total of 138 articles were considered and included in our analysis. Among these articles, 29 (21.01%) were authored by females, while 109 (78.99%) were authored by males. To conclude, this research study reveals a rising trend of females in lead authorship roles within the field of cardiac arrhythmia research. However, it remains evident that there is a significant gender gap, with male researchers still outnumbering their female counterparts.
PubMed: 38022330
DOI: 10.7759/cureus.47208 -
JACC. Clinical Electrophysiology Apr 2018
Topics: Animals; Child; Death, Sudden, Cardiac; Humans; Wolff-Parkinson-White Syndrome; Wolves
PubMed: 30067482
DOI: 10.1016/j.jacep.2017.11.014 -
Journal of Investigative Medicine High... 2018A 24-year-old man with history of unspecified arrhythmia presented with palpitations and chest pain. Initial electrocardiogram (ECG) revealed irregular tachycardia with...
A 24-year-old man with history of unspecified arrhythmia presented with palpitations and chest pain. Initial electrocardiogram (ECG) revealed irregular tachycardia with varying QRS width: 150 to 200 beats per minute for narrow complexes and 300 beats per minute for wide complexes. Following cardioversion, ECG revealed sinus tachycardia with a preexcitation pattern of positive delta waves in the anterolateral leads and negative delta waves in inferior leads. The patient remained in sinus rhythm and underwent successful ablation of a right posteroseptal accessory pathway. Subsequent ECG showed upright T waves in the leads I, aVL, and V2-6, large inverted T waves in leads III and aVF, and no delta waves. This case serves as an important reminder that atrial fibrillation (AF) in the presence of an accessory pathway may present with confounding ECG features, potentially leading to incorrect diagnoses and treatments that may be life threatening. Despite 10% to 30% prevalence of AF in the presence of an accessory pathway and the relative awareness of Wolff-Parkinson-White syndrome among general internal medicine providers, the clinical recognition of Wolff-Parkinson-White syndrome may be hindered in the presence of preexcited AF.
PubMed: 30283806
DOI: 10.1177/2324709618802870 -
Indian Pacing and Electrophysiology... 2020Atrial fibrillation (AF) with preexcitation can be life threatening. Our study evaluated the incidence, clinical features, electrophysiologic characteristics and...
AIMS AND OBJECTIVES
Atrial fibrillation (AF) with preexcitation can be life threatening. Our study evaluated the incidence, clinical features, electrophysiologic characteristics and outcomes of patients presenting with AF and fast ventricular rates associated with an antegrade conducting accessory pathway.
METHODS
Hospital data of patients who had undergone electrophysiology study and radiofrequency ablation for AF and Wolff-Parkinson-White (WPW) syndrome was retrospectively evaluated over 10 years and prospective data was further collected over 1 year. Out of 2876 patients undergoing electrophysiology study, 320 patients had manifest preexcitation on ECG. Forty one patients who had presented with AF and fast ventricular rates were included in the study.
RESULTS
Forty one (12.8%) patients out of 320 patients of WPW syndrome patients presented with AF and fast ventricular rates. Mean age of presentation was 38.5 ± 12.3 yrs. Twenty nine (72.5%) were male. Most common presenting features were palpitations, presyncope and syncope. Twenty eight (71.1%) patients were electrically cardioverted on presentation, of which two patients having narrow complex tachycardia, when given adenosine, developed AF and fast ventricular rates and had to be electrically cardioverted. Intravenous amiodarone converted AF to sinus rhythm in 11 (28.9%) patients. Right postero-septal pathway (33.3%) followed by coronary sinus epicardial pathway (22.9%) were the most commonly located pathways associated with AF. Five (12.2%) patients had multiple pathways. CS diverticulum was seen in 6 (14.7%) patients. Ablation was done during AF in 6 (14.7%) patients. All except one had immediate successful ablation. One patient had a recurrence of preexcitation on follow up and successfully ablated during redo procedure.
CONCLUSION
AF with WPW syndrome is not uncommon. AF is commonly associated with posteriorly located accessory pathways, CS diverticulum and multiple pathways. Radiofrequency ablation has good outcomes.
PubMed: 31945418
DOI: 10.1016/j.ipej.2019.12.015 -
Cureus Jul 2020Wolff-Parkinson-White (WPW) syndrome is an uncommon form of cardiac preexcitation due to an underlying structural accessory pathway, which may lead to potentially lethal...
Wolff-Parkinson-White (WPW) syndrome is an uncommon form of cardiac preexcitation due to an underlying structural accessory pathway, which may lead to potentially lethal arrhythmias. Classic electrocardiogram (ECG) findings of WPW include short PR interval, slurred upstroke of the QRS complex, and prolonged QRS duration. However, in intermittent preexcitation, a rare variant in contrast to continuous preexcitation, these findings are not always present, thus masking a diagnosis of WPW syndrome. Consequently, this may adversely affect or delay the appropriate treatment of short-term tachyarrhythmias and long-term definitive therapies for this syndrome. The emergency physician should promptly obtain an ECG after the termination of any tachyarrhythmia, and maintain a high index of suspicion for intermittent preexcitation with typical WPW ECG findings which were not present on prior studies. The authors present a case of a 17-year-old female diagnosed with an intermittent preexcitation variant of WPW syndrome after a case of successfully treated symptomatic supraventricular tachycardia (SVT).
PubMed: 32766013
DOI: 10.7759/cureus.8971