The Wolff-Parkinson-White syndrome: problems in evaluation and surgical therapy.
نویسندگان
چکیده
Two patients with WPW syndrome underwent surgery to ablate accessory conduction pathways. Endocardial and epicardial mapping in both patients had indicated an area of early right ventricular depolarization. Surgical transection of the areas of early depolarization failed in both cases to normalize the electrocardiogram. In the first patient, additional resection in the area of the A-V node failed to produce heart block and the ECG remained abnormal. However, the paroxysmal tachycardia ceased, and she has remained asymptomatic and active 12 months after surgery. In the second patient, as the A-V node was about to be sectioned, pressure and procaine near the A-V node caused the ECG to normalize transiently and after resection permanently. Microscopic study of this tissue showed "P cells." Postoperatively the patient demonstrated normal A-V nodal function. He was discharged with a normal ECG but expired soon after discharge. Postmortem examination of the heart demonstrated the A-V node and bundle of His plus the location of the resection adjacent to the bundle of His. These two cases illustrate disparities between electrophysiologic mapping and actual site of the accessory conduction pathway. In one of the cases an accessory bundle was demonstrated histologically.
منابع مشابه
Radiofrequency catheter ablation in the treatment of Wolff-Parkinson-White syndrome
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This article discusses a patient with Wolff-Parkinson-White syndrome who recently underwent surgical ablation of her accessory pathway at West Virginia University Health Sciences Center. Surgical cure of this arrhythmia is possible in a high percentage of cases and should be strongly considered for those with life-threatening arrhythmias or poorly controlled symptoms.
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عنوان ژورنال:
- Circulation
دوره 42 1 شماره
صفحات -
تاریخ انتشار 1970