During the electrophysiologic study of 435 patients referred for evaluation of Wolff-Parkinson-White syndrome, 42 (10%) had preexcited reciprocating tachycardia (defined as a macro-reentrant tachycardia that used an accessory atrioventricular [AV] pathway for antegrade conduction). The ages of the patients ranged from 9 to 67 years (27 +/- 14). Thirty-three were male patients, nine female, and ...

We report a 26-year-old woman with frequent episodes of palpitation and dizziness. Resting electrocardiography showed no evidence of ventricular preexcitation. During electrophysiologic study, a concealed right posteroseptal accessory pathway was detected and orthodromic atrioventricular reentrant tachycardia incorporating this pathway as a retrograde limb was reproducibly induced. After succes...

An electrophysiological study was performed on a 39-year-old woman with recurrent palpitations. She initially presented in 1985 with atrial fibrillation, ventricular preexcitation, and a rapid ventricular response. At that time, she underwent open heart surgery, and mapping demonstrated multiple posteroseptal and left free wall accessory pathways. Accessory pathway conduction was abolished surg...

BACKGROUND Rapid anterograde conduction in the setting of ventricular preexcitation is associated with an increased risk of sudden cardiac death. The effect of isoproterenol in this setting is unclear, particularly in younger anesthetized patients. The aim of this study was to determine the effect of isoproterenol on accessory-pathway conduction in children undergoing general anesthesia and its...

WPW syndrome is a rare congenital heart disease due to an accessory pathway between the atrium and the ventricle. Its ECG pattern is characterized by a short PR interval, a delta wave, a wide QRS complex and an abnormal ventricular repolarisation. Patients are usually asymptomatic, or have frequent paroxysmal episodes of tachycardia. These tachycardias are supraventricular tachycardias related ...

His bundle ablation was performed in a 48 year old man with drug refractory orthodromic atrioventricular reentrant tachycardia and paroxysmal atrial fibrillation. Reentry was caused by a left free wall concealed accessory pathway. Interruption of the His bundle by low energy direct current shock (25 J) was quickly followed by anterograde conduction via the accessory pathway, with various forms ...

OBJECTIVE To evaluate characteristics of patients and accessory pathways as well as additional technical factors involved in the reappearance of accessory pathway conduction after successful ablation. DESIGN Analysis of recurrences after radiofrequency ablation. SETTING 163 consecutive patients with 167 accessory pathways. SUBJECTS 97 men and 66 women with a mean (SD) age of 36 (14) range...

A case of permanent unintentional ablation of an accessory pathway during electrophysiological study is reported. Possible factors predisposing to such ablation include the location and depth below the endocardium of the accessory pathway.

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...

pathway and subtle preexcitation, the AH intervals were short. These data pertain to a predominantly adult population. Only 1 of the patients was <12 years old. This patient showed a minimal preexcitation pattern and the pathway was in the left lateral region. These data cannot be extrapolated to the pediatric population, in general, who may have relatively shorter atrioventricular nodal conduc...