2001, Number 1
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Arch Cardiol Mex 2001; 71 (1)
Sudden death in intermittent wolff parkinson white syndrome
Medeiros A, Iturralde P, Guevara M, Mendoza C, Colín L
Language: Spanish
References: 15
Page: 59-65
PDF size: 217.84 Kb.
ABSTRACT
Sudden death is a rare condition in asymptomatic patients with asymptomatic intermittent Wolff Parkinson syndrome (WPW); for this reason it is believed that these patients should not undergo to radiofrequency ablation. We report an asymptomatic 44 year old man who developed ventricular fibrillation with a pre-excited RR interval less than 200 msec during atrial fibrillation, as a first manifestation of WPW syndrome. The Holter monitoring showed intermittent pre-excitation at low heart rate (70 bpm). During the electrophysiological study a successfully radiofrequency catheter ablation of a right posteroseptal accessory pathway was performed. We concluded that intermittent pre-excitation may not be used to identify patients who are at risk of sudden death. Radiofrequency catheter ablation should be recommended in those patients with a very high success rate, and a low incidence of serious complications.
REFERENCES
García-Cosío F: Sudden death in the Wolff-Parkinson-White syndrome. Rev Esp Cardiol 1989; 42: 234-239.
Timmermans C, Smeets JM, Rodríguez LM, Vrouchos G, Van den Dool A, Wellens HJ: Aborted sudden death in the Wolff-Parkinson-White syndrome. Am J Cardiol 1995; 76(7): 492-494.
Jackman WM, Wang X, Friday KJ, Roman CA, Moulton KP, Beckman KJ, et al: Catheter ablation of accessory Atrioventricular Pathways (Wolff-Parkinson-White syndrome) by Radiofrequency Curren. N Engl J Med 1991; 324: 1605-1611.
Iturralde TP, Colín LL, Guevara VM, Rodríguez CHL, Kershenovich SS: Experiencia en 1,500 pacientes sometidos a ablación con radiofrecuencia en el tratamiento de las taquicardias. Arch Inst Cardiol Mex 2000; 70: 349-366.
Goudevenos JA, Graekas G, Argiri O, Giogiakas V, Sideris DA: Ventricular pre-excitation in the general population: A study on the mode of presentation and clinical course. Heart 2000. 83(1): 29-34.
Prystowsky EN, Fananapazir L, Packer DL, Thompson KA, German LD: Wolff-Parkinson-White syndrome and sudden cardiac death. Cardiology 1987; 74(Suppl 2): 67-71.
Chugh SS, Kelly KL, Titus JL: Sudden death with apparently normal heart. Circulation 2000; 102(6): 649-654.
Al-Khatib SM, Pritchett ELC: Clinical features of Wolff-Parkinson-White syndrome. Am Heart J 1999; 138: 403-413.
Wellens HJ, Rodríguez LM, Timmermans C, Smeets JM: The Asymptomatic patient with the Wolff-Parkinson-White electrocardiogram. Pacing Clin Electrophysiol 1997; 20(8): 2082-2086.
Klein GJ, Bashore TM, Sellers TD, Pritchett ELC, Smith WM, Gallager JJ: Ventricular fibrillation in the Wolff-Parkinson-White syndrome. N Engl J Med y 1979; 301: 1080-1085.
Torner P: European Registry on Sudden Death in the Wolff-Parkinson-White syndrome. Ventricular fibrillation in the Wolff-Parkinson-White syndrome. Circulation 1988; 78(II): 23.
Morady F, Kadish AH, Schalmatz S, Summit J: Effects of resting vagal tone on accessory atrioventricular connections. Circulation 1990; (81): 86-90.
Herweg B, Toosi B, Fisher JD, Ferrick JK: Autonomic modulation and atrial fibrillation in the Woff-Parkinson-White syndrome. Am J Cardiol 2000; 85(10): 1256-1259.
Brembilla-Perrot B, Ghawi R: Electrophysiological characteristics of asymptomatic Wolff-Parkinson-White syndrome. Eur Heart J 1993; 14(4): 511-515.
Antunes E, Rasteiro R, Martins S, Oliveira M, Oliveira E, Menezes M, et. al: Should all patients with ventricular pre-excitation of the Wolff-Parkinson-White syndrome type undergo catheter ablation? Rev Port Cardiol 1999; 18(6): 611-615.