Multiple accessory pathways in patients with the pre-excitation syndrome.
- 1 October 1976
- journal article
- case report
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 54 (4), 571-591
- https://doi.org/10.1161/01.cir.54.4.571
Abstract
We have studied 135 patients with the pre-excitation syndrome and have demonstrated evidence of multiple accessory pathways in 20 patients. Five patients had two distinct accessory atrioventricular (A-V) connections, associated with enhanced A-V node conduction in one patient. Twelve patients had a single accessory A-V connection associated with enhanced A-V conduction. In one of these there was an additional fasciculo-ventricular connection. One patient had an accessory A-V connection associated with a nodoventricular bundle. Two patients had fasciculo-ventricular connections combined with enhanced A-V conduction. The latter two patients had electrocardiograms suggestive of a complete accessory A-V connection. Patients with enhanced A-V conduction had shorter cycle lengths during reciprocating tachycardia, primarily because of a short A-H during the dysrhythmia, than those without such conduction. In addition, patients with enhanced A-V conduction demonstrated more rapid conduction from atrium to His bundle during induced atrial fibrillation and two developed life-threatening ventricular responses during atrial fibrillation. A nodo-ventricular pathway was documented to participate in reciprocating tachycardia in one patient. Surgery was undertaken in 13 patients. In 11, the intraoperative mapping studies confirmed the preoperative predictions. In two patients, the presence of a second accessory A-V connection was documented after ablation of one.Keywords
This publication has 23 references indexed in Scilit:
- Electrophysiologic demonstration of bilateral anomalous pathways in a patient with Wolff-Parkinson-White syndrome (type B preexcitation)The American Journal of Cardiology, 1976
- Retrograde atrial preexcitation following premature ventricular beats during reciprocating tachycardia in the Wolff-Parkinson-White syndromeThe American Journal of Cardiology, 1976
- Coexistence of functional Kent and Mahaim-type tracts in the pre-excitation syndrome. Demonstration by catheter techniques and epicardial mapping.Circulation, 1975
- Altered refractory periods in patients with short P-R intervals and normal QRS complexThe American Journal of Cardiology, 1975
- Electrophysiology of atrial pacing in patients with short PR interval, normal QRS complexAmerican Heart Journal, 1975
- Basis of static and dynamic electrocardiographic variations in Wolff-Parkinson-White syndrome: Anatomic and electrophysiologic observations in right and left ventricular preexcitationThe American Journal of Cardiology, 1973
- Electrophysiologic studies in the syndrome of short P-R interval, normal QRS complexThe American Journal of Cardiology, 1973
- Wolff-Parkinson-White syndrome: Report of a case with both type A and type B pre-excitationThe American Journal of Cardiology, 1964
- Morphology of the human atrioventricular node, with remarks pertinent to its electrophysiologyAmerican Heart Journal, 1961
- Kent's fibers and the A-V paraspecific conduction through the upper connections of the bundle of His-TawaraAmerican Heart Journal, 1947