Atrial fibrillation in the Wolff-Parkinson-White syndrome

Pietersen, Adrian; Andersen, E; Sandøe, Erik

doi:10.1016/0002-9149(92)91076-g

Cited by 53 publications

(28 citation statements)

References 8 publications

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“…Rare cases of patients with intermittent preexcitation and cardiac arrest have been reported. 19 Moreover, patients with intermittent preexcitation are still at risk for AV re-entrant tachycardia with retrograde activation of the atria via AP. 20 In our group, AV re-entrant tachycardia was inducible in 2 of 7 patients with intermittent preexcitation.…”

Section: Discussionmentioning

confidence: 99%

Electrophysiologic Profile and Results of Invasive Risk Stratification in Asymptomatic Children and Adolescents With the Wolff–Parkinson–White Electrocardiographic Pattern

Kubuš

Vit

Gebauer

et al. 2014

Circ: Arrhythmia and Electrophysiology

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Background-Data on the results and clinical effect of an invasive risk stratification strategy in asymptomatic young patients with the Wolff-Parkinson-White electrocardiographic pattern are scarce. Methods and Results-Eighty-five consecutive patients aged <18 years with a Wolff-Parkinson-White pattern and persistent preexcitation at maximum exercise undergoing invasive risk stratification were retrospectively studied. Adverse accessory pathway (AP) properties were defined according to currently consented criteria as any of the following: shortest preexcited RR interval during atrial fibrillation/rapid atrial pacing ≤250 ms (or antegrade effective refractory period ≤250 ms if shortest preexcited RR interval was not available) or inducible atrioventricular re-entrant tachycardia. Age at evaluation was median 14.9 years. Eighty-two patients had a structurally normal heart and 3 had hypertrophic cardiomyopathy. A single manifest AP was present in 80, 1 manifest and 1 concealed AP in 4, and 2 manifest APs in 1 patient. Adverse AP properties were present in 32 of 85 patients (37.6%) at baseline and in additional 16 of 44 (36.4%) after isoproterenol. Ablation was performed in 41 of these 48 patients. Ablation was deferred in the remaining 7 for pathway proximity to the atrioventricular node. In addition, 18 of the low-risk patients were ablated based on patient/parental decision. Conclusions-Adverse AP properties at baseline were exhibited by 37.6% of the evaluated patients with an asymptomatic Wolff-Parkinson-White preexcitation persisting at peak exercise. Isoproterenol challenge yielded additional 36.4% of those tested at higher risk. Ablation was performed in a total of 69.4% of patients subjected to invasive risk stratification. (Circ Arrhythm Electrophysiol. 2014;7:218-223.)

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Section: Discussionmentioning

confidence: 99%

Electrophysiologic Profile and Results of Invasive Risk Stratification in Asymptomatic Children and Adolescents With the Wolff–Parkinson–White Electrocardiographic Pattern

Kubuš

Vit

Gebauer

et al. 2014

Circ: Arrhythmia and Electrophysiology

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“…In a follow-up study of 241 patients with WPW syndrome, 26 patients had documented atrial fibrillation (11%). These patients were followed for 15 years and 2 of the 26 died suddenly [34].…”

Section: Risk Of Wolff-parkinson-white (Wpw) For Young Athletesmentioning

confidence: 99%

Update: Causes and symptoms of sudden cardiac death in young athletes

Asif

Yim

Hoffman

et al. 2015

The Physician and Sportsmedicine

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Sudden cardiac death (SCD) is the leading cause of death during exercise. While initial reports suggested that the most common cause of SCD in young athletes was due to hypertrophic cardiomyopathy (HCM), a critical review of investigations in several populations (athletes, non-athletes, military, national, and international) supports that the most common finding at autopsy of young individuals with SCD is actually a structurally normal heart (SNH). This information is vital for sports medicine clinicians, especially with regard to the pre-participation evaluation (PPE) since cardiac death associated with a SNH is likely attributed to disorders such as arrhythmia or ion channel diseases. This comprehensive review explores the causes of SCD, along with the symptoms preceding death, which ultimately may help refine the PPE and maximize the ability to detect potentially lethal disease prior to competition.

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“…Varying degrees of fusion beats can also be found. Short effective refractory period of accessory pathway1 and short R-R interval between consecutive pre-excited complexes2 are associated with rapid ventricular rates that can degenerate into ventricular fibrillation3 and sudden death.…”

Section: Discussionmentioning

confidence: 99%

A young man with tachycardia

2001

Postgraduate Medical Journal

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A 23 year old man presented to the casualty department with right periorbital oedema. A diagnosis of urticaria was made, antihistamines were prescribed, and he was discharged home. Within 24 hours he returned complaining of increased facial swelling and dysphagia, and a medical opinion was sought. He denied recent facial trauma, or insect stings. Further inquiry revealed that he had suVered a similar episode nine months earlier which had involved swelling of his hands and feet. These areas were not itchy or red. His past history included recurrent bouts of abdominal pain associated with distension and vomiting requiring numerous hospital admissions under the care of diVerent consultants over the previous 14 years. A diagnosis of abdominal migraine was frequently recorded. There were no obvious precipitating factors and the bouts resolved spontaneously over a period of a few days. Detailed family history uncovered several members with similar symptoms and an inheritance pattern along the maternal line. Examination revealed a slim built, normotensive 23 year old man with bilateral periorbital, perioral, and pharyngeal oedema. He was comfortable at rest with no drooling, dyspnoea, or wheeze (fig 1). Routine investigations showed a normal full blood count, urea and electrolytes, liver function tests, and chest x ray film. The suspected diagnosis of C1 esterase inhibitor (C1 INH) deficiency was confirmed with low C1 INH and C4 concentrations at 0.08 g/l (normal 0.15-0.35) and <0.06 g/l (normal 0.20-0.60) respectively.In view of the frequency and severity of his symptoms he was started on prophylactic treatment with danazol. He was advised that he would require intravenous infusions of C1 INH concentrate as prophylaxis before any future surgical intervention and review would be needed before future dental work. He was discharged with a Medic Alert bracelet and arrangements were made to screen other family members. To date, three years later, there have been no further relapses.

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Atrial fibrillation in the Wolff-Parkinson-White syndrome

Cited by 53 publications

References 8 publications

Electrophysiologic Profile and Results of Invasive Risk Stratification in Asymptomatic Children and Adolescents With the Wolff–Parkinson–White Electrocardiographic Pattern

Electrophysiologic Profile and Results of Invasive Risk Stratification in Asymptomatic Children and Adolescents With the Wolff–Parkinson–White Electrocardiographic Pattern

Update: Causes and symptoms of sudden cardiac death in young athletes

A young man with tachycardia

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