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Cardiology Journal 2022
Topics: Accessory Atrioventricular Bundle; Catheter Ablation; Child; Electrocardiography; Humans; Physical Functional Performance; Pilot Projects; Pre-Excitation Syndromes; Wolff-Parkinson-White Syndrome
PubMed: 35621093
DOI: 10.5603/CJ.a2022.0027 -
International Journal of Cardiology Mar 2013Electrocardiographic criteria of preexcitation syndrome are sometimes not visible on ECG in sinus rhythm (SR). The purpose of the study was to evaluate the significance...
UNLABELLED
Electrocardiographic criteria of preexcitation syndrome are sometimes not visible on ECG in sinus rhythm (SR). The purpose of the study was to evaluate the significance of unapparent preexcitation syndrome in SR, when overt conduction through accessory pathway (AP) was noted at atrial pacing.
METHODS
Anterograde conduction through atrioventricular AP was identified at electrophysiological study (EPS) in 712 patients, studied for tachycardia (n=316), syncope (n=89) or life-threatening arrhythmia (n=55) or asymptomatic preexcitation syndrome (n=252). ECG in SR at the time of EPS was analysed.
RESULTS
78 patients (11%) (group I) had a normal ECG in SR and anterograde conduction over AP at atrial pacing; 634 (group II) had overt preexcitation in SR. Group I was as frequently asymptomatic (35%) as group II (35%), had as frequently tachycardias, syncope or life-threatening arrhythmia as group II (43, 5, 2% vs 43, 13, 8%). AP was more frequently left lateral in group I (57%) than in group II (36%)(p<0.001). AV re-entrant tachycardia, atrial fibrillation (AF), antidromic tachycardia were induced as frequently in group I (54, 18, 10%) as in group II (54, 27, 7%). Malignant forms (induced AF with RR intervals between preexcited beats <250ms in control state or <200ms after isoproterenol) were as frequent in group I (11.5%) as II (14%).
CONCLUSIONS
The frequency of unapparent preexcitation syndrome represents 11% of our population with anterograde conduction through an AP and could be underestimated. The risk to have a malignant form is as high as in patients with overt preexcitation syndrome in SR.
Topics: Adolescent; Adult; Diagnostic Errors; Electrocardiography; Female; Humans; Male; Middle Aged; Pre-Excitation Syndromes; Retrospective Studies; Young Adult
PubMed: 21704397
DOI: 10.1016/j.ijcard.2011.06.051 -
Circulation. Arrhythmia and... Nov 2023The cause of hypertrophic cardiomyopathy (HCM) in the young is highly varied. Ventricular preexcitation (preexcitation) is well recognized, yet little is known about the...
BACKGROUND
The cause of hypertrophic cardiomyopathy (HCM) in the young is highly varied. Ventricular preexcitation (preexcitation) is well recognized, yet little is known about the specificity for any cause and the characteristics of the responsible accessory pathways (AP).
METHODS
Retrospective cohort study of patients <21 years of age with HCM/preexcitation from 2000 to 2022. The cause of HCM was defined as isolated HCM, storage disorder, metabolic disease, or genetic syndrome. Atrioventricular AP (true AP) were distinguished from fasciculoventricular fibers (FVF) using standard invasive electrophysiology study criteria. AP were defined as high risk if any of the following were <250 ms: shortest preexcited RR interval in atrial fibrillation, shortest paced preexcited cycle length, or anterograde AP effective refractory period.
RESULTS
We identified 345 patients with HCM and 28 (8%) had preexcitation (isolated HCM, 10/220; storage disorder, 8/17; metabolic disease, 5/19; and genetic syndrome, 5/89). Six (21%) patients had clinical atrial fibrillation (1 with shortest preexcited RR interval <250 ms). Twenty-two patients underwent electrophysiology study which identified 23 true AP and 16 FVF. Preexcitation was exclusively FVF mediated in 8 (36%) patients. Five (23%) patients had AP with high-risk conduction properties (including ≥1 patient in each etiologic group). Multiple AP were seen in 8 (36%) and AP plus FVF in 10 (45%) patients. Ablation was acutely successful in 13 of 14 patients with recurrence in 3. One procedure was complicated by complete heart block after ablation of a high-risk midseptal AP. There were significant differences in QRS amplitude and delta wave amplitude between groups. There were no surface ECG features that differentiated AP from FVF.
CONCLUSIONS
Young patients with HCM and preexcitation have a high likelihood of underlying storage disease or metabolic disease. Nonisolated HCM should be suspected in young patients with large QRS and delta wave amplitudes. Surface ECG is not adequate to discriminate preexcitation from a benign FVF from that secondary to potentially life-threatening AP.
Topics: Humans; Retrospective Studies; Atrial Fibrillation; Electrocardiography; Pre-Excitation Syndromes; Accessory Atrioventricular Bundle; Cardiomyopathy, Hypertrophic; Metabolic Diseases; Wolff-Parkinson-White Syndrome
PubMed: 37877314
DOI: 10.1161/CIRCEP.123.012191 -
The American Journal of Emergency... Nov 2013The preexcitation syndrome may either simulate myocardial infarction (MI) or mask it. The rapid anterograde conduction through accessory pathway may obscure...
The preexcitation syndrome may either simulate myocardial infarction (MI) or mask it. The rapid anterograde conduction through accessory pathway may obscure atrioventricular (AV) block of the normal AV-nodal tract. To our knowledge, the case of various degree AV-nodal and bypass tract block after MI in a patient with preexcitation syndrome has been infrequently reported. We report a complex case of preexcitation syndrome presenting with first-degree and transient third-degree AV blocks in both normal and accessory pathways after acute MI. Subsequently, we further discuss the diagnosis of MI in preexcitation syndrome and analyze the electrocardiographic character of AV block in preexcitation syndrome.
Topics: Accessory Atrioventricular Bundle; Aged, 80 and over; Atrioventricular Block; Atrioventricular Node; Electrocardiography; Heart; Humans; Male; Myocardial Infarction; Pre-Excitation Syndromes
PubMed: 23890485
DOI: 10.1016/j.ajem.2013.06.019 -
Annals of Noninvasive Electrocardiology... Nov 2016Preexcitation syndrome could affect terminal QRS vector, which is not emphasized in clinic. In this study, we made a comparison between vectorcardiogram (VCG) before and...
BACKGROUND
Preexcitation syndrome could affect terminal QRS vector, which is not emphasized in clinic. In this study, we made a comparison between vectorcardiogram (VCG) before and after ablation to observe the change of terminal QRS vector. Furthermore, the relationship between the change of terminal QRS vector and accessory pathway (AP) as well as the change of initial QRS vector (delta vector) was analyzed.
METHODS
Thirty patients who were proved to have a single AP by ablation were included. All patients were divided into seven groups based on the AP location. Comparison between VCG before and after ablation was made to observe the change of terminal and delta vector. The relationship between the change of terminal QRS vector and AP location as well as delta vector was analyzed.
RESULTS
(1) All 30 patients had a change in terminal QRS vector (elevation and/or azimuth) in comparison to postablation VCG. (2) The change of terminal QRS vector was related to delta vector and AP location. The agreement and consistency between the change of terminal QRS vector and delta vector were 91.65% and 0.856 (P < 0.01), respectively.
CONCLUSIONS
(1) Both initial and terminal QRS vector are affected by the antegrade conduction of AP. The change of terminal QRS vector is related to the AP location and delta vector. (2) The effect of preexcitation syndrome on QRS terminal vector is shown as more intuitive and easy in spatial vector by comparison with electrocardiogram, which is helpful for the diagnosis of atypical preexcitation and localization of AP.
Topics: Accessory Atrioventricular Bundle; Adolescent; Adult; Aged; Catheter Ablation; Child; Electrocardiography; Female; Humans; Middle Aged; Pre-Excitation Syndromes; Treatment Outcome; Vectorcardiography
PubMed: 26820616
DOI: 10.1111/anec.12347 -
Pacing and Clinical Electrophysiology :... Jan 2016
Topics: Cardiology; Diagnosis, Differential; Electrocardiography; Evidence-Based Medicine; Guideline Adherence; Humans; Practice Guidelines as Topic; Pre-Excitation Syndromes; Prognosis; Risk Assessment
PubMed: 26391534
DOI: 10.1111/pace.12745 -
Cardiology Journal 2022In contrast to adults, in whom cardiac rhythm disorders are mainly conditioned by coronary artery disease, in children, arrhythmias are most often associated with...
BACKGROUND
In contrast to adults, in whom cardiac rhythm disorders are mainly conditioned by coronary artery disease, in children, arrhythmias are most often associated with inherited heart disorders. Catheter ablation (CA) has an important role in the management of cardiac arrhythmias, in adults and children. The aim of the study was to assess and compare the efficacy and safety of CA in children and adults with preexcitation syndrome.
METHODS
The study population comprised 43 adults and 43 children diagnosed with a Wolff-Parkinson-White syndrome (WPW). The mean age of the study population was 41 ± 15 years for adults and 14 ± 2.5 years for children. In all patients, an electrophysiological study and CA were performed. Analysis with respect to the procedure duration, fluoroscopy exposure time, location of accessory pathways (AP), immediate success rate and complications were performed.
RESULTS
Electrophysiological study revealed the most frequent presence of left-sided AP (56% in children and 70% in adults). The mean procedure duration was 96 ± 36 min and 106 ± 51 min in children and adults, respectively (p = NS). The mean fluoroscopy duration was 8.5 ± 4.3 min and 5.9 ± 5.8 min in children and adults, respectively p < 0.05. The CA procedure was successful in 40 out of 43 (93%) adults and in 36 out of 43 (83.7%) children (p = NS). In 2 (4%) children minor complications occurred.
CONCLUSIONS
Ablation in children and adults are equally effective with respect to short-term clinical observation.
Topics: Accessory Atrioventricular Bundle; Adult; Arrhythmias, Cardiac; Catheter Ablation; Child; Humans; Middle Aged; Pre-Excitation Syndromes; Treatment Outcome; Wolff-Parkinson-White Syndrome
PubMed: 32207846
DOI: 10.5603/CJ.a2020.0030 -
Journal of Cardiovascular... Nov 2005Family studies, and more recent molecular genetic investigations, indicate that the Wolff-Parkinson-White (WPW) syndrome and associated preexcitation disorders can have... (Review)
Review
Family studies, and more recent molecular genetic investigations, indicate that the Wolff-Parkinson-White (WPW) syndrome and associated preexcitation disorders can have a substantial genetic component. Because preexcitation disorders are sometimes inherited as single gene disorders, key mechanistic insights can be gained that are expected to be relevant also to the more common multifactorial forms of these traits. Potentially, such insights will inform the future management of these conditions. Where WPW is inherited as a familial trait, with or without associated cardiac defects or a systemic syndrome, there are clinical genetic ramifications that are already of practical importance.
Topics: Genetic Predisposition to Disease; Genetic Testing; Humans; Mutation; Pre-Excitation Syndromes; Wolff-Parkinson-White Syndrome
PubMed: 16302915
DOI: 10.1111/j.1540-8167.2005.50139.x -
Nihon Rinsho. Japanese Journal of... Nov 1991
Topics: Adult; Electrocardiography; Heart Conduction System; Humans; Male; Pre-Excitation Syndromes
PubMed: 1770591
DOI: No ID Found -
Circulation May 2024
Topics: Humans; Hypertrophy, Left Ventricular; Electrocardiography; Male; Pre-Excitation Syndromes; Wolff-Parkinson-White Syndrome
PubMed: 38739693
DOI: 10.1161/CIRCULATIONAHA.124.069364