The present investigation evaluates the ability of several electrocardiographic (ECG) and electrophysiologic methods to identify multiple accessory pathways in 47 patients in whom the presence and sites of multiple accessory pathways were confirmed intraoperatively. To establish ECG features that suggested the presence of multiple accessory pathways in these patients, we initially studied the 1...

A patient with W-P-W syndrome (type A) and disabling supraventricular tachycardia was studied with epicardial mapping prior to surgical interruption of the circus pathway. Analysis of the delta vector and results of the epicardial mapping strongly suggested aberrant pathway located very posteriorly and crossing the atrioventricular sulcus in or adjacent to the interventricular septum. A circus ...

A patient with W-P-W syndrome (type A) and disabling supraventricular tachycardia was studied with epicardial mapping prior to surgical interruption of the circus pathway. Analysis of the delta vector and results of the epicardial mapping strongly suggested aberrant pathway located very posteriorly and crossing the atrioventricular sulcus in or adjacent to the interventricular septum. A circus ...

A subset of children and adults with Wolff-Parkinson-White (WPW) syndrome develop dilated cardiomyopathy (DCM). Although DCM may occur in symptomatic WPW patients with sustained tachyarrhythmias, emerging evidence suggests that significant left ventricular dysfunction may arise in WPW in the absence of incessant tachyarrhythmias. An invariable electrophysiological feature in this non-tachyarrhy...

It is clinically important to be able to detect the presence of an accessory pathway, as pre-excited atrial fibrillation is a well recognised cause of sudden cardiac death, for which there is a potential "cure" in the form of radiofrequency ablation of the pathway. The classic manifestations such as a shortened PR interval or delta waves may not always be present. In certain patients a pseudo p...

BACKGROUND Catheter ablation with the use of radiofrequency current has been introduced as a therapeutic option for patients with tachyarrhythmias mediated by an accessory atrioventricular pathway. The technique conventionally implies the introduction of several catheters into the heart for assessment of electrophysiological parameters as well as for localization of the accessory pathway and ma...

Premature atrial stimulation and His bundle recordings were performed in 6 patients with pre-excitation (WPW) syndrome. The ventricular rates during bursts of atrialflutter and atrialfibrillation triggered by the earliest impulses depended on the functional properties of the accessory pathway. In 3 patients in whom the effective refractory period of the accessory pathway was longer than that of...