The noninvasive localization of the accessory pa thway (AP) responsible for ventricular preexcitation is helpful in the initial evaluation of patients with Wolff-Parkinson-White (WPW) syndrome. Recently, two groups of authors independently published new classifications derived from the correlation of 12-lead ECG with electrophysiologic studies. ~'2 Although these classifications allow a more pr...

Introduction During orthodromic atrioventricular reentrant tachycardia (AVRT), ventricles are activated anterogradely through the atrioventricular node and retrogradely through an accessory pathway (AP). Antiarrhythmic drugs are initially used to prevent recurrences of AVRT, whereas catheter ablation is frequently performed as a definitive treatment. Occasionally, catheter ablation can be “proa...

A 55-year-old man was admitted to our hospital for further examination of the abnormalities of chest X-ray and electrocardiogram. He was diagnosed with type B Wolff-Parkinson-White syndrome concomitant with dilated cardiomyopathy. Despite the medical therapy using enalapril and carvedilol for 20 months, his cardiac performance and brain natriuretic peptide (BNP) were not so improved. Because as...

Among patients with Wolff-Parkinson-White syndrome, atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) can coexist in a single patient. Direct transition of both tachycardias is rare; however, it can occur after premature atrial or ventricular activity if the cycle lengths of the two tachycardias are similar. Furthermore, persistent atrial...

The case of a patient with narrow QRS-complex supraventricular tachycardia and atrial flutter is described. The 12-lead surface electrocardiogram (ECG) revealed sinus rhythm with ventricular pre-excitation and negative δ waves in leads II, III and aVF, indicating Wolff-Parkinson-White syndrome with a posteroseptal accessory pathway (AP). Coronary sinus angiography revealed the presence of a div...

A 24-year-old male with Wolff-Parkinson-White syndrome developed systolic cardiomyopathy and severe heart failure following membranous ventricular septal defect repair and tricuspid valve replacement. Following successful catheter ablation of a right anterolateral accessory pathway (AP), complete AV block with junctional escape rhythm was noted. Patient subsequently underwent implantation of a ...

BACKGROUND Cardiac memory is a phenomenon characterized by transient T-wave abnormalities occurring during normal sinus rhythm, after a period of altered ventricular depolarization, where the T-wave vector has the same direction as the vector of the previously altered QRS complex (T-wave inversion). It is a form of electrical remodelling of the ventricular, where the T-wave follows ("remembers"...

Background: The non-Doppler echocardiographic technique known as two-dimensional speckle tracking echocardiography (2D-STE) has been demonstrated to help assess dyssynchrony and allow quantification of cardiac deformity timing in 2D greyscale images. This study evaluated the role accessory pathway (AP) localization compared electrophysiology (EPS) gold standard technique. Methods: was performed...

A 32-year-old man underwent catheter ablation of an orthodromic atrioventricular reentrant tachycardia. The sinus rhythm electrocardiogram exhibited a normal PQ interval and no delta waves, but atrial pacing produced a prolonged PQ interval and wide QRS morphology with right bundle-branch block due to antegrade accessory pathway (AP) conduction. During the tachycardia, atrial double potentials ...

Atriofascicular accessory pathways (AP), often referred to as Mahaim pathways, are uncommon electrical connections that most often course along the lateral right atrium and insert within the distal right bundle branch (RBB). Pathognomomic electrophysiological characteristics are well described, including unidirectional anterograde conduction with AV node–like decremental properties. Reported ta...