The mystery of asymptomatic Wolff-Parkinson-White syndrome.
نویسنده
چکیده
induced with rapid atrial pacing, which subsequently degenerated to ventricular fibrillation. During the same procedure the accessory pathway was successfully ablated and the boy could resume his intensive sporting activity. This case illustrates a possible high risk condition, but what is the chance of clinical occurrence of this arrhythmia and could this arrhythmia endanger the life of this young patient? This question was hotly debated in the last decade. The debate is based on unanimously accepted facts and arguable assumptions based on surrogates. First described in the early 1940s [4], ventricular fibrillation complicating WPW is well known. In 1971, for the first time, ventricular fibrillation was shown by Dreifus et al. [5] to be clearly linked with atrial fibrillation. Wellens and Durrer [6] elegantly demonstrated that the accessory pathway refractory period determines the ventricular rate during atrial fibrillation in WPW and this relationship is linear. The classic work on ventricular fibrillation in patients with WPW was published in 1979 by Klein at al. [7]. These researchers compared 31 patients with WPW and documented ventricular fibrillation with 73 patients who also had WPW but did not have a history of ventricular fibrillation. Significantly more patients in the VF group had a history of atrial fibrillation and symptomatic tachycardia. In six patients the VF was caused by digitalis administration during atrial fibrillation. Electrophysiologically, 16% of the patients in the VF group had multiple pathways compared to 5% in the other patients. The accessory pathway refractory period
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ورودعنوان ژورنال:
- The Israel Medical Association journal : IMAJ
دوره 12 11 شماره
صفحات -
تاریخ انتشار 2010