We present the case of a 25 year-old man referred for an electrophysiological study due to suspected pre-excitation as the cause of two recent syncopal episodes. The admission electrocardiogram (ECG) showed a borderline PR interval of 120 ms and apparently small delta waves visible in leads V2-V4. Intracardiac recordings showed a short HV interval of 18 ms that was stable despite decremental at...

This is a report of a 10-year-old child who underwent surgery for complex congenital heart disease consisting of corrected transposition of the great vessels, ventricular septal defect, patent ductus arterisus, severe left-sided atrioventricular (AV) valve insuffieicney (Ebstein's deformity) and Wolff-Parkinson-White syndrome. The site of his accessory AV connection was localized preoperatively...

Ten patients with Wolff-Parkinson-White syndrome underwent cardiac electrophysiological study extended to include the induction of atrial fibrillation at maximum exercise in the upright position. This was performed using a new temporary bipolar lead with a helical active fixation tip for atrial pacing. The highest rate of atrioventricular conduction via the accessory pathway was greater during ...

BACKGROUND Accessory pathways may be located in close proximity to the His bundle, resulting in a high risk of heart block during attempted surgical or electrical interruption of these pathways. This study reports the prevalence, ECG characteristics, and results of catheter ablation of parahissian accessory pathways. They were defined on the basis of both the presence of a high amplitude (> 0.1...

This review is aimed at discussing the diagnostic value of the different electrocardiographic criteria so far described in the differential diagnosis of the major forms of paroxysmal supraventricular tachycardias (PSVTs). The predictive value of different combinations of these independent electrocardiographic (ECG) signs in distinguishing atrioventricular reentrant tachycardias (AVRTs) through ...

Electrophysiological data consistent with atrioventricular nodal dysfunction were obtained in 10 out of 19 patients with progressive systemic sclerosis (scleroderma). Conducting system studies were carried out in a further seven patients with progressive systemic sclerosis. In each the proximal portion of the atrioventricular node was consistently found to be smaller and more slender. It is pos...

The appearance of syncope in a patient with an accessory pathway is often a sign of high conduction capacity along the pathway, and calls for urgent ablation. Serious complications may ensue if it is assumed that these patients have an underlying mechanism of tachyarrhythmia, and ablation of the accessory pathway performed hastily without careful electrophysiological evaluation may lead to seri...

transcatheteraortic valve implantation, first introduced in 2002, has been established as an alternative modality for patients deemed not suitable for open-heart surgery. the anatomical vicinity of the atrioventricular node and the his bundle to the non-coronary and rightcoronary aortic cusps predisposes patients to conduction abnormalities in case of severe calcification or mechanical trauma d...

Reciprocating tachycardia in a patient with a leftsided atrioventricular accessory pathway (AP) (Kent bundle, type A) capable only of ventriculo-atrial (V-A) transmission is described. The V-A AP is established as an essential link of the tachycardia circuit, as evidenced by: 1) retrograde atrial activation of the left atrium (LA) 60 msec or more before the low and high right atrium during reci...

BACKGROUND We have developed a noninvasive isochrone activation imaging (AI) system with 3-dimensional (3D) speckle tracking echocardiography (STE), which allows visualization of the wavefront image of mechanical propagation of the accessory pathway (ACP) in Wolff-Parkinson-White syndrome. METHODS AND RESULTS Patients with manifest Wolff-Parkinson-White syndrome were imaged in 3D-STE AI mode,...