Estimation of the accessory pathway location of the manifest Wolf-Parkinson-White syndrome using synthesized right-sided chest leads
ConclusionsQRS morphology of syn-V4R lead may be useful for predicting accessory pathway location of manifest WPW syndrome.
CONCLUSION: High-risk antegrade conduction properties are exhibited by more than one-quarter of asymptomatic children and adolescents with WPW. Ablation should be considered as a first-line therapy in asymptomatic children and adolescents with high-risk WPW. PMID: 31802767 [PubMed - in process]
In this volume of The Journal, Chubb et al report the results of a survey of pediatric cardiac electrophysiologists on the management of patients identified with the Wolff-Parkinson-White (WPW) pattern on electrocardiogram (ECG) with no symptoms. They report that many electrophysiologists are being more aggressive about using invasive electrophysiology studies with subsequent ablation as treatment than the most current guidelines would suggest.
The rising utilization of screening electrocardiograms has resulted in increased incidental identification of ventricular pre-excitation in pediatric patients. We compared accessory pathways of incidentally identified pre-excitation to Wolff-Parkinson-White Syndrome (WPW) with the aim to identify factors important in pre-procedural counseling and planning. This single-center, retrospective study of patients ≤18y without congenital heart disease identified 227 patients diagnosed with pre-excitation and referred for invasive electrophysiology study between 2008 - 2017.
Fasciculoventricular fibers (FVFs) are responsible for 1-5% of cases of asymptomatic pre-excitation on surface electrocardiogram (ECG). Unlike ventricular pre-excitation seen in Wolff-Parkinson-White (WPW) syndrome, FVFs are not associated with sudden cardiac death from pre-excited atrial fibrillation.
This case report describes a patient with syncope and an electrocardiographic finding of Wolff-Parkinson-White pattern.
ECG in Ebstein’s anomaly of tricuspid valve ECG in Ebstein’s anomaly of tricuspid valve ECG in Ebstein’s anomaly of tricuspid valve showing right axis deviation of QRS, notched R waves in II, III, aVF and V1 suggesting fragmented QRS. Peaked P waves indicate a right atrial abnormality, though the typical voltage criteria for right atrial enlargement (more than 0.25 mV) is not satisfied. Fragmented QRS occurs in Ebstein’s anomaly due to abnormal conduction in the atrialised right ventricle . A portion of the right ventricle is atrialised because of distal displacement of the septal and posterior ...
Bilge AK Abstract A 31-year-old male patient presented with complaints of palpitations, dizziness, and recurrent episodes of syncope. A 12-lead electrocardiogram (ECG) revealed manifest ventricular preexcitation, which suggested Wolff Parkinson White syndrome. In addition, an incomplete right bundle branch block and a 3-mm ST segment elevation ending with inverted T-waves in V2 were consistent with coved-type (type 1) Brugada pattern. An electrophysiological study was performed, and during the mapping, the earliest ventricular activation with the shortest A-V interval was found on the mitral annulus posterolatera...
We examined the range of normal left ventricular size and function in the main study cohort (schoolchildren 11-14 yr old). We defined diagnostic criteria for hr-CVC and compared the cardiac measurements of these younger participants with those of older children whom we examined (age, 15-18 yr). From 5,169 completed diagnostic studies (mean participant age, 13.06 ± 1.78 yr), CMR results revealed 76 previously undiagnosed cases of hr-CVC (1.47% of the total cohort): 11 of dilated cardiomyopathy (14.5%), 3 of nonobstructive hypertrophic cardiomyopathy (3.9%), 23 ACAOS-IM cases (30.3%; 6 left-ACAOS and 17 right-ACAOS), ...
Ebstein's anomaly is often accompanied by either Wolff-Parkinson-White syndrome or atriofascicular Mahaim. These bypass tracts give rise to antidromic atrioventricular (AV) re-entrant tachycardias, in which the bypass tract serves as the anterograde limb of the circuit and the AV node as the retrograde limb of the reentrant circuit. Since the antidromic AV reentrant tachycardia over a Mahaim fibre has a typically left bundle braunch block (LBBB) morphology, it is easy to make a misdiagnosis of supraventricular tachycardia with functional LBBB or even of ventricular tachycardia particularly in the presence of negative concordance.
CONCLUSIONS: The most effective strategy to screen athletes for cardiovascular disease was ECG. This test was 5 times more sensitive than history and 10 times more sensitive than PE, and it had a higher positive likelihood ratio, lower negative likelihood ratio, and lower false-positive rate than history or PE. The 12-lead ECG interpreted using modern criteria should be considered the best practice in screening athletes for cardiovascular disease, and the use of history and PE alone as screening tools should be reevaluated. PMID: 29154691 [PubMed - as supplied by publisher]