Differentiating fasciculoventricular pathway from Wolff-Parkinson-White syndrome by electrocardiography

Suzuki, Tsugutoshi; Nakamura, Yoshihide; Yoshida, Shuichiro; Yoshida, Yoko; Shintaku, Haruo

doi:10.1016/j.hrthm.2013.11.018

Cited by 33 publications

(38 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This becomes clinically important given the risk of life threatening events that are associated with WPW syndrome, particularly in the presence of a high prevalence of atrial arrhythmias . FVP can potentially be differentiated from WPW syndrome through a noninvasive adenosine challenge test . Based on our EPS findings in the two prior patients, we performed an adenosine challenge on the subsequent patient which successfully ruled out a rapidly conducting accessory atrioventricular pathway.…”

Section: Discussionmentioning

confidence: 99%

“…Fasciculoventricular pathways (FVP) are accessory connections that cause ventricular preexcitation and are difficult to distinguish from Wolff‐Parkinson‐White (WPW) syndrome on surface ECG. This clinical distinction is pertinent given the risk of sudden death with WPW syndrome in contrast to the benign clinical course of FVP . While a higher association of FVP has been recently reported in patients with hypertrophic cardiomyopathy and PRKAG2 variants, there is scarce literature on their presence in Danon disease .…”

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Arrhythmias and fasciculoventricular pathways in patients with Danon disease: A single center experience

Jhaveri

Herber

Zahka

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

Background Danon disease is a rare X‐linked storage disorder characterized by hypertrophic cardiomyopathy leading to arrhythmias and heart failure. A preexcitation pattern on electrocardiogram (ECG) has been described in these patients, however, invasive studies to distinguish between Wolff‐Parkinson‐White syndrome syndrome and fasciculoventricular pathways (FVP) are limited. Objectives The purpose of this study was to delineate the electrophysiological cardiac abnormalities in patients with Danon disease and to describe the presence of FVP in this population. Methods We performed a retrospective study of all patients with a confirmed diagnosis of Danon disease presenting to a single center from May 2005 to May 2018. Baseline demographics, clinical characteristics, ECG findings, and electrophysiology study (EPS) results were collected. Results Ten patients with Danon disease (30% male, average age 17.4 years) were identified. Seven patients (70%) had tachyarrhythmias including five with atrial arrhythmias and six with nonsustained ventricular tachycardia. Preexcitation pattern on ECG was found in four (40%) patients. Of these, two underwent an EPS which confirmed the presence of an FVP. One patient underwent an adenosine challenge which supported a FVP. Implantable cardioverter defibrillator was placed in five patients for primary prevention with no patients receiving an appropriate discharge. Over a follow‐up of 5.3 years, five underwent heart transplantation. Conclusions This study reports a high incidence of FVP in patients with Danon disease and preexcitation. It underscores an alternate etiology of preexcitation in this population which can potentially be diagnosed without invasive EPS testing. Future multicenter studies are needed to expand this experience.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Arrhythmias and fasciculoventricular pathways in patients with Danon disease: A single center experience

Jhaveri

Herber

Zahka

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

show abstract

“…Our own series included 19 patients . Additional large cohorts have included 22, 23, and 24 patients, respectively . In another of our studies, we found that 8 of 392 of patients referred for electrophysiologic testing had fasciculo‐ventricular pathways .…”

Section: Fasciculo‐ventricular Pathwaysmentioning

confidence: 79%

Unusual variants of pre‐excitation: From anatomy to ablation: Part III—Clinical presentation, electrophysiologic characteristics, when and how to ablate nodoventricular, nodofascicular, fasciculoventricular pathways, along with considerations of permanent junctional reciprocating tachycardia

Correa

Lokhandwala²,

Sánchez‐Quintana

et al. 2019

Cardiovasc electrophysiol

View full text Add to dashboard Cite

The recognition of the presence, location, and properties of unusual accessory pathways for atrioventricular conduction is an exciting, but frequently a difficult, challenge for the clinical cardiac arrhythmologist. In this third part of our series of reviews, we discuss the different steps required to come to the correct diagnosis and management decision in patients with nodofascicular, nodoventricular, and fasciculo‐ventricular pathways. We also discuss the concealed accessory atrioventricular pathways with the properties of decremental retrograde conduction that are associated with the so‐called permanent form of junctional reciprocating tachycardia. Careful analysis of the 12‐lead electrocardiogram during sinus rhythm and tachycardias should always precede the investigation in the catheterization room. When using programmed electrical stimulation of the heart from different intracardiac locations, combined with activation mapping, it should be possible to localize both the proximal and distal ends of the accessory connections. This, in turn, should then permit the determination of their electrophysiologic properties, providing the answer to the question “are they incorporated in a tachycardia circuit?”. It is this information that is essential for decision‐making with regard to the need for catheter ablation, and if necessary, its appropriate site.

show abstract

“…But, the degree of preexcitation remains unaltered in the case of an FVP. Similarly, during atrial ectopic beats the preexcitation may increase when there is an AVP whereas it would remain constant in the case of FVP …”

Section: Commentarymentioning

confidence: 99%

“…In contrast, QRS get fully preexcited when there is AV block if there is an AVP. Adenosine stress testing can be a useful non‐invasive method in differentiating AVP from FVP . Finally, preexcitation FVP may cause intermittent preexcitation though the exact mechanism is unknown …”

Section: Commentarymentioning

confidence: 99%

Atrio‐Hisian block precludes preexcitation—What is the mechanism?

Prabhu

Shekhar

Pai

et al. 2018

Journal of Arrhythmia

View full text Add to dashboard Cite

Differentiating fasciculoventricular pathway from Wolff-Parkinson-White syndrome by electrocardiography

Cited by 33 publications

References 11 publications

Arrhythmias and fasciculoventricular pathways in patients with Danon disease: A single center experience

Arrhythmias and fasciculoventricular pathways in patients with Danon disease: A single center experience

Unusual variants of pre‐excitation: From anatomy to ablation: Part III—Clinical presentation, electrophysiologic characteristics, when and how to ablate nodoventricular, nodofascicular, fasciculoventricular pathways, along with considerations of permanent junctional reciprocating tachycardia

Atrio‐Hisian block precludes preexcitation—What is the mechanism?

Contact Info

Product

Resources

About