Early Repolarization and Its Modification by Preexcitation in Two Patients with Intermittent Wolff‐Parkinson‐White Syndrome

Abstract

We report two cases of intermittent Wolff-Parkinson-White (WPW) syndrome. In one patient, early repolarization (ER) was masked during preexcitation whereas in the other, J wave-like notches were observed in the right precordial leads only during preexcitation. The clinical significance of ER is not apparent in WPW syndrome but some possible mechanisms are discussed.

EKG Findings Mimicking Pericarditis and STEMI in a patient with Ventricular Preexcitation: A Case Report

“…Soon thereafter, another rhythm strip obtained in the emergency department was similar (Figure 2) . Same findings are seen on 12-lead EKG as well (Figure 3) , with ST-elevation localized to inferior leads mimicking inferior ST Elevated Myocardial Infarction (STEMI) [2]. Interestingly, an EKG obtained five minutes later showed a different pattern: widespread minimal concave-upwards ST elevation with PR depression in lead II (Figure 4) .…”

“…This has implications for correct diagnosis and management of patients [6]. We could find only five documented cases showing transient ST elevation in patients with WPW pattern [1,2,[5][6][7]. To our knowledge, this is the first report of WPW pattern mimicking pericarditis on EKG showing both widespread ST elevation and PR segment depression in lead II.…”

Atrial arrhythmias in inherited arrhythmogenic disorders

“…In terms of ERS, the strongest relationship exists among patients with Wolff–Parkinson–White syndrome (WPWS) [19] , [20] , [21] , [22] , [23] , [24] , [25] . The prevalence of inferolateral early repolarization (ER) pattern has been reported to be approximately 40–50% in patients with WPWS prior to and after catheter ablation [22] , [23] .…”