Pre-excited atrial fibrillation revealed at a very delayed age: case report

Abstract

Background Wolff-Parkinson-White (WPW) syndrome is a condition characterized by the persistence of an accessory pathway responsible for ventricular pre-excitation that can lead to symptomatic and potentially severe arrhythmias. Coexistence with atrial fibrillation is well known and not uncommon, exposing to potential degenerescence into ventricular fibrillation when atrial impulses are transmitted along the accessory pathway. WPW syndrome is most prevalent in younger patients and cases revealed after an advanced age have rarely been described in the literature. Case presentation Here, we report a case of atrial pre-excitation first diagnosed at the age of 72 years that required external electrical cardioversion with a favorable outcome. The diagnosis was based on clinical and electrographic findings. Conclusions WPW syndrome is a relatively rare cardiac disorder that can be a cause of sudden death, especially when combined with atrial fibrillation. Therefore, cardiologists have to consider this diagnosis in patients presenting clinical signs of arrhythmia with an electrical pattern of WPW.

Pre-excitation Syndrome Unveiling Ebstein Anomaly at an Exceptionally Advanced Age

“…The reason for this is that these medications can block the normal electrical pathway through the AV node, thereby forcing the electrical impulses to use the accessory pathway, increasing the risk of rapid ventricular response, which can lead to hemodynamic instability and adverse outcomes. 3 The complex anatomic features associated with Ebstein anomaly, such as a significantly enlarged right heart, a displaced tricuspid annulus, and distorted anatomic landmarks, can pose increased difficulties during catheter ablation procedures. Achieving and maintaining catheter stability can be challenging due to these factors, as experienced in our case.…”

“…Among these cases, about 30% involve multiple accessory pathways, and around 10% exhibit atypical conduction properties. 3 Numerous publications have documented cases of Ebstein anomaly that are associated with atrial arrhythmias, especially in young people, as severe cases can lead to early mortality. To the best of our knowledge, this case is the first of pre-excited atrial fibrillation as the revealing mode of Ebstein anomaly in a 71-year-old individual.…”

Thyroid and Its Ripple Effect: Impact on Cardiac Structure, Function, and Outcomes

“…Hypothyroidism, marked by diminished thyroid hormone levels, results in a decline in contractility due to compromised calcium regulation and decreased expression of contractile proteins. On the other hand, hyperthyroidism, characterized by high levels of thyroid hormones, can lead to increased heart muscle contraction, which may make the heart more susceptible to disorders like atrial fibrillation (AF) and hypertrophic cardiomyopathy [ 16 ]. The physiological effects of changes in myocardial contractility caused by the thyroid extend beyond the cellular level and affect the overall functionality of the heart.…”

Advancements in the Management of Endocrine System Disorders and Arrhythmias: A Comprehensive Narrative Review

“…These findings offer opportunities for personalized treatment and risk prediction. Genetic markers related to thyroid dysfunction have been identified, allowing for a better understanding of the genetic susceptibility to conditions like Graves' disease and Hashimoto's thyroiditis [22]. Genomic profiling has been instrumental in identifying mutations in ion channel genes responsible for long QT syndrome (LQTS) [23].…”

“…Biomarkers like brain natriuretic peptide (BNP) and N-terminal pro-BNP have emerged as predictors of AF recurrence and severity [22]. Additionally, circulating microRNAs have shown potential as diagnostic and prognostic biomarkers in AF.…”