Determinants of antegrade echo zone in the Wolff-Parkinson-White syndrome.

نویسندگان

  • E L Pritchett
  • J J Gallagher
  • M Scheinman
  • W M Smith
چکیده

Forty-five patients with the Wolff-Parkinson-White syndrome and reciprocating tachycardia which utilized the atrioventricular (A-V) node for antegrade conduction and an accessory pathway for ventriculo-atrial (retrograde) conduction were studied. The extrastimulus technique in the right atrium and coronary sinus at multiple pacing cycle lengths was used. Three types of "echo zones" were defined by the relationship of the antegrade effective refractory period (ERP) of the accessory pathway, the longest coupling interval accompanied by an atrial echo, the ERP of the A-V node, and the functional refractory period of the atrium. Eighteen of 45 patients (40%) had more than one type of echo zone demonstrated by changing either pacing site or pacing cycle length or both. Pacing site and intraventricular conduction delay were found to have important effects on the longest coupling interval accompanied by an atrial echo in those echo zones in which the longest coupling interval accompanied by an atrial echo was less than the antegrade ERP of the accessory pathway. The echo zone is a useful concept to explain the physiology of the common reciprocating tachycardia in patients with the Wolff-Parkinson-White syndrome. However, the echo zone is profoundly affected by pacing site and pacing cycle length. When these variables are changed, many patients can be shown to have more than one type of echo zone. Studies of the echo zone have limited value as therapeutic guides.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Radiofrequency catheter ablation in the treatment of Wolff-Parkinson-White syndrome

Introduction: Tachyarrhythmias in Wolf Parkinson White (WPW) syndrome, can be a life threatening factor. Antiarrhythmic drug therapy in this syndrome, has not been completely acceptable. Efficacy, safety and economy of Radio Frequency Catheter Ablation (RFCA) in western studies, has made it as the treatment of choice. In the present study, efficacy of RFCA in the ablation of accessory pathway...

متن کامل

Determinants of atrioventricular reentrant paroxysmal tachycardia in patients with Wolff-Parkinson-White syndrome.

Normal and anomalous pathway properties were evaluated in 50 patients with preexcitation to discover determinants of paroxysmal supraventricular tachycardia (PSVT). Twenty-eight patients had inducible PSVT and 22 had no inducible PSVT. Patients with inducible PSVT had: 1) ability for retrograde anomalous pathway conduction demonstrated with ventricular pacing at short paced cycle lengths (< 429...

متن کامل

Electrophysiological evaluation of the Wolff-Parkinson-White syndrome: problems in assessing antegrade and retrograde conduction over the accessory pathway.

The effect of atrial pacing and recording site and ventricular pacing site on assessment of conduction over the accessory pathway (AP) was examined in a group of patients with the Wolff-Parkinson-White syndrome. The importance of initial localization of the AP by recording the sequence of retrograde atrial activation during circus movement tachycardia is demonstrated. Inability to record or pac...

متن کامل

Analysis of Re - entry Mechanisms in Three Patients with Concealed Wolff - Parkinson - White Syndrome

Three patients with recurring attacks of supraventricular tachycardia and no electrocardiographic evidence of the Wolff-Parkinson-White syndrome (WPW syndrome) were studied using intracardiae recordings and atrial stimulation. The findings are interpreted as evidence of a concealed WPW syndrome. In all patients there was antegrade block of the anomalous atrioventricular (A-V) pathway while retr...

متن کامل

Analysis of re-entry mechanisms in the three patients with concealed Wolff-Parkinson-White syndrome.

Three patients with recurring attacks of supraventricular tachycardia and no electrocardiographic evidence of the Wolff-Parkinson-White syndrome (WPW syndrome) were studied using intracardiac recordings and atrial stimulation. The findings are interpreted as evidence of a concealed WPW syndrome. In all patients there was antegrade block of the anomalous atrioventricular (A-V) pathway while retr...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Circulation

دوره 57 4  شماره 

صفحات  -

تاریخ انتشار 1978