Mata CLA; Roque CJJ; Pérez GJA; García MC, Vegas PC, Mata CC, Vegas PL, Companioni SY

Language: Spanish
References: 16
Page: 338-342
PDF size: 601.43 Kb.

ABSTRACT

Atrial fibrillation by accessory pathway is a dangerous disease that can cause sudden death, it is rare and it needs a careful management, even more, if a pattern of ventricular pre-excitation appears. The case of a white skin 17-year-old teenager with a history of short palpitations at moderate effort, and occasional loss of consciousness of short duration, without other associated symptoms, is presented. At the moment of admission, he presents palpitations, fatigue, pallor and low blood pressure; in the electrocardiogram a tachycardia with wide, irregular QRS, with delta wave and rapid ventricular rate is observed, which was interpreted as pre-excited atrial fibrillation. Synchronized electrical cardioversion to QRS with 100 joules was performed, and sinus rhythm was restored with electrocardiographic pattern of ventricular pre-excitation (Wolff-Parkinson-White syndrome).

REFERENCES

1. Moya-I-Mitjans Á, Rivas-Gándara N, Sarrias-Mercè A, Pérez-Rodón J, Roca-Luque I. Síncope. Rev Esp Cardiol. 2012;65(8):755-65.

2. Larraitz G, Marchlinski FE, Betensky BP. Mecanismos de las arritmias. Rev Esp Cardiol. 2012;65(2):174-85.

3. Altamirano R. Alternativas terapéuticas en la fibrilación auricular. Rev Med Las Condes. 2018;29(1):69-75.

4. Forero-Gómez JE, Moreno JM, Agudelo CA, Rodríguez-Arias EA, Sánchez-Moscoso PA. Fibrilación auricular: enfoque para el médico no cardiólogo. Iatreia. 2017;30(4):404-22.

5. Macle L, Cairns J, Leblanc K, Tsang T, Skanes A, Cox JL, et al. 2016 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation. Can J Cardiol. 2016;32(10):1170-85.

6. Pava-Molano LF, Perafán-Bautista PE. Generalidades de la fibrilación auricular. Rev Colomb Cardiol. 2016;23(Supl 5):5-8.

7. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893-962.

8. Almendral J, Castellanos E, Ortiz M. Taquicardias paroxísticas supraventiculares y síndromes de preexcitación. Rev Esp Cardiol. 2012;65(5):456-69.

9. Cis-Spoturno A, Valenzuela-Candelario L, López-Zea M, Beas-Jiménez JD. Preexcitación ventricular: dificultad en el tratamiento de un caso de Wolff-Parkinson-White en un deportista. Rev Andal Med Deporte. 2014;7(2):90-3.

10. Puga Bravo M, Navia Intriago OL, Gómez Hernández A, Gómez Núñez K. Fibrilación auricular por vía accesoria. Rev Cuban Cardiol [Internet]. 2018 [citado 19/11/2019];24(2). Disponible en: http://revcardiologia.sld.cu/index.php/revcardiologia/article/view/739/pdf_124

11. González Zuelgaray J, Abud AM, Abud M, Picolini A, Szyszko AE. Fibrilación auricular en situaciones especiales. Rev Urug Cardiol. 2016;31(1):138-64.

12. Baron-Esquivias G, Martínez-Alday J, Martín A, Moya A, García-Civera R, Paz López-Chicharro M, et al. Epidemiological characteristics and diagnostic approach in patients admitted to the emergency room for transient loss of consciousness: Group for Syncope Study in the Emergency Room (GESINUR) study. Europace. 2010;12(6):869-76.

13. Restrepo-Jaramillo CA. Cardioversión farmacológica. Rev Colomb Cardiol. 2016;23(Supl. 5):52-6.

14. Negrete-Salcedo A, Gil-Roncancio E. Estrategias para el control de la frecuencia cardíaca en pacientes con fibrilación auricular. Rev Colomb Cardiol. 2016;23(Supl 5):108-11.

15. Cain N, Irving C, Webber S, Beerman L, Arora G. Natural history of Wolff-Parkinson-White syndrome diagnosed in childhood. Am J Cardiol. 2013;112(7):961-5.

16. Santinelli V, Radinovic A, Manguso F, Vicedomini G, Gulletta S, Paglino G, et al. The natural history of asymptomatic ventricular pre-excitation a long-term prospective follow-up study of 184 asymptomatic children. J Am Coll Cardiol. 2009;53(3):275-80.