Atrial fibrillation with a very rapid ventricular response as the first clinical arrhythmia in a 76-year-old man.
Identifieur interne : 000351 ( Ncbi/Checkpoint ); précédent : 000350; suivant : 000352Atrial fibrillation with a very rapid ventricular response as the first clinical arrhythmia in a 76-year-old man.
Auteurs : Béatrice Brembilla-Perrot [France] ; Pierre Houriez ; Daniel Beurrier ; Pierre Louis ; Michel Boursier ; Khalifé KhaliféSource :
- Pacing and clinical electrophysiology : PACE [ 0147-8389 ] ; 2003.
English descriptors
- KwdEn :
- MESH :
- physiopathology : Atrial Fibrillation, Heart Conduction System, Wolff-Parkinson-White Syndrome.
- surgery : Atrial Fibrillation, Wolff-Parkinson-White Syndrome.
- Aged, Catheter Ablation, Exercise Test, Humans, Male.
Abstract
The interest of electrohysiological study for the prognostic evaluation of asymptomatic Wolff-Parkinson-White (WPW) syndrome remains controversial. We report the case of an asymptomatic 67-year-old man without heart disease in whom a type A WPW syndrome was noted. Because the WPW was unchanged during exercise testing, transesophageal EPS was performed. In basal state, 1/1 conduction through the Kent bundle was noted up to a rate of 210 beats/min. After infusion of 30 microg of isoproterenol, atrial pacing was associated with a 1/1 conduction throughout the Kent bundle at a rate at 300 beats/min and induced rapid atrial fibrillation which was stopped by flecainide. No treatment was indicated. Nine years later, at age 76, the patient developed syncope related to rapid atrial fibrillation requiring cardioversion. In conclusion, the occurrence of a potentially lethal supraventricular tachyarrhythmia in a previously asymptomatic patient with WPW syndrome might be encountered in elderly patients. Transesophageal electrophysiological evaluation is a useful means to predict this risk.
PubMed: 12877714
Affiliations:
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pubmed:12877714Le document en format XML
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<front><div type="abstract" xml:lang="en">The interest of electrohysiological study for the prognostic evaluation of asymptomatic Wolff-Parkinson-White (WPW) syndrome remains controversial. We report the case of an asymptomatic 67-year-old man without heart disease in whom a type A WPW syndrome was noted. Because the WPW was unchanged during exercise testing, transesophageal EPS was performed. In basal state, 1/1 conduction through the Kent bundle was noted up to a rate of 210 beats/min. After infusion of 30 microg of isoproterenol, atrial pacing was associated with a 1/1 conduction throughout the Kent bundle at a rate at 300 beats/min and induced rapid atrial fibrillation which was stopped by flecainide. No treatment was indicated. Nine years later, at age 76, the patient developed syncope related to rapid atrial fibrillation requiring cardioversion. In conclusion, the occurrence of a potentially lethal supraventricular tachyarrhythmia in a previously asymptomatic patient with WPW syndrome might be encountered in elderly patients. Transesophageal electrophysiological evaluation is a useful means to predict this risk.</div>
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<name sortKey="Houriez, Pierre" sort="Houriez, Pierre" uniqKey="Houriez P" first="Pierre" last="Houriez">Pierre Houriez</name>
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<country name="France"><region name="Grand Est"><name sortKey="Brembilla Perrot, Beatrice" sort="Brembilla Perrot, Beatrice" uniqKey="Brembilla Perrot B" first="Béatrice" last="Brembilla-Perrot">Béatrice Brembilla-Perrot</name>
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