An Unusual Mechanism of Initiation of Circus Movement Tachycardia in a Patient with Concealed Wolff‐Parkinson‐White Syndrome
Identifieur interne : 000D40 ( Main/Corpus ); précédent : 000D39; suivant : 000D41An Unusual Mechanism of Initiation of Circus Movement Tachycardia in a Patient with Concealed Wolff‐Parkinson‐White Syndrome
Auteurs : William G. Stevenson ; James WeissSource :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 1983-05.
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Abstract
Infranodal conduction delay is an uncommon mechanism of initiation of circus movement tachycardia in the Wolff‐Parkinson‐White syndrome. A patient with a concealed left free wall atrioventricular accessory pathway who underwent electrophysiological study is presented. During alrial extrastimulus testing, a pattern ofalter‐nating bundle branch block was observed and was most marked after the administration of intravenous procainamide. Conversion from right bundle branch block to left bundle branch block was reproducibly associated with the initiation of circus movement tachycardia utilizing the normal conducting system anfegradely and the accessory pathway retrogradely. Initiation of tachycardia was critically related to the increase in the HV interval associated with left bundle branch block. Of interest, conduction in the right bundle branch became progressively slower as the prematurity of the atrial extrastimulus increased, whereas conduction time through the left bundle branch remained fixed prior to block. Implications of these findings are discussed. To our knowledge, this is thefirst report of alternating bundle branch block during atrial extrastimulus testing as a mode of initiation of circus movement tachycardia in the Wolff‐Parkinson‐White syndrome.
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DOI: 10.1111/j.1540-8159.1983.tb05329.x
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Stevenson</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, UCLA School of Medicine, Los Angeles, California</mods:affiliation></affiliation></author><author><name sortKey="Weiss, James" sort="Weiss, James" uniqKey="Weiss J" first="James" last="Weiss">James Weiss</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, UCLA School of Medicine, Los Angeles, California</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:5D4CD6CEDEAC7A337A6ADFA9A891C40295417466</idno><date when="1983" year="1983">1983</date><idno type="doi">10.1111/j.1540-8159.1983.tb05329.x</idno><idno type="url">https://api.istex.fr/document/5D4CD6CEDEAC7A337A6ADFA9A891C40295417466/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000D40</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">An Unusual Mechanism of Initiation of Circus Movement Tachycardia in a Patient with Concealed Wolff‐Parkinson‐White Syndrome</title><author><name sortKey="Stevenson, William G" sort="Stevenson, William G" uniqKey="Stevenson W" first="William G." last="Stevenson">William G. Stevenson</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, UCLA School of Medicine, Los Angeles, California</mods:affiliation></affiliation></author><author><name sortKey="Weiss, James" sort="Weiss, James" uniqKey="Weiss J" first="James" last="Weiss">James Weiss</name><affiliation><mods:affiliation>Department of Medicine, Division of Cardiology, UCLA School of Medicine, Los Angeles, California</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Pacing and Clinical Electrophysiology</title><idno type="ISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1983-05">1983-05</date><biblScope unit="volume">6</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="702">702</biblScope><biblScope unit="page" to="707">707</biblScope></imprint><idno type="ISSN">0147-8389</idno></series><idno type="istex">5D4CD6CEDEAC7A337A6ADFA9A891C40295417466</idno><idno type="DOI">10.1111/j.1540-8159.1983.tb05329.x</idno><idno type="ArticleID">PACE702</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0147-8389</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Wolff‐Parkinson‐White syndrome</term><term>alternating bundle branch block</term><term>clinical electrophysiology</term><term>infranodal conduction delay</term><term>reciprocating tachycardia</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Infranodal conduction delay is an uncommon mechanism of initiation of circus movement tachycardia in the Wolff‐Parkinson‐White syndrome. A patient with a concealed left free wall atrioventricular accessory pathway who underwent electrophysiological study is presented. During alrial extrastimulus testing, a pattern ofalter‐nating bundle branch block was observed and was most marked after the administration of intravenous procainamide. Conversion from right bundle branch block to left bundle branch block was reproducibly associated with the initiation of circus movement tachycardia utilizing the normal conducting system anfegradely and the accessory pathway retrogradely. Initiation of tachycardia was critically related to the increase in the HV interval associated with left bundle branch block. Of interest, conduction in the right bundle branch became progressively slower as the prematurity of the atrial extrastimulus increased, whereas conduction time through the left bundle branch remained fixed prior to block. Implications of these findings are discussed. To our knowledge, this is thefirst report of alternating bundle branch block during atrial extrastimulus testing as a mode of initiation of circus movement tachycardia in the Wolff‐Parkinson‐White syndrome.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>WILLIAM G. 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A patient with a concealed left free wall atrioventricular accessory pathway who underwent electrophysiological study is presented. During alrial extrastimulus testing, a pattern ofalter‐nating bundle branch block was observed and was most marked after the administration of intravenous procainamide. Conversion from right bundle branch block to left bundle branch block was reproducibly associated with the initiation of circus movement tachycardia utilizing the normal conducting system anfegradely and the accessory pathway retrogradely. Initiation of tachycardia was critically related to the increase in the HV interval associated with left bundle branch block. Of interest, conduction in the right bundle branch became progressively slower as the prematurity of the atrial extrastimulus increased, whereas conduction time through the left bundle branch remained fixed prior to block. Implications of these findings are discussed. 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A patient with a concealed left free wall atrioventricular accessory pathway who underwent electrophysiological study is presented. During alrial extrastimulus testing, a pattern ofalter‐nating bundle branch block was observed and was most marked after the administration of intravenous procainamide. Conversion from right bundle branch block to left bundle branch block was reproducibly associated with the initiation of circus movement tachycardia utilizing the normal conducting system anfegradely and the accessory pathway retrogradely. Initiation of tachycardia was critically related to the increase in the HV interval associated with left bundle branch block. Of interest, conduction in the right bundle branch became progressively slower as the prematurity of the atrial extrastimulus increased, whereas conduction time through the left bundle branch remained fixed prior to block. Implications of these findings are discussed. 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Weiss, M.D., UCLA School of Medicine, 47‐123 CHS, Los Angeles, CA 90024.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">1983-05</dateIssued><edition>Received May 4,1982; revision July 2,1982; accepted August 27, 1982.</edition><copyrightDate encoding="w3cdtf">1983</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="references">13</extent></physicalDescription><abstract lang="en">Infranodal conduction delay is an uncommon mechanism of initiation of circus movement tachycardia in the Wolff‐Parkinson‐White syndrome. A patient with a concealed left free wall atrioventricular accessory pathway who underwent electrophysiological study is presented. During alrial extrastimulus testing, a pattern ofalter‐nating bundle branch block was observed and was most marked after the administration of intravenous procainamide. Conversion from right bundle branch block to left bundle branch block was reproducibly associated with the initiation of circus movement tachycardia utilizing the normal conducting system anfegradely and the accessory pathway retrogradely. Initiation of tachycardia was critically related to the increase in the HV interval associated with left bundle branch block. Of interest, conduction in the right bundle branch became progressively slower as the prematurity of the atrial extrastimulus increased, whereas conduction time through the left bundle branch remained fixed prior to block. Implications of these findings are discussed. To our knowledge, this is thefirst report of alternating bundle branch block during atrial extrastimulus testing as a mode of initiation of circus movement tachycardia in the Wolff‐Parkinson‐White syndrome.</abstract><subject lang="en"><genre>Keywords</genre><topic>alternating bundle branch block</topic><topic>Wolff‐Parkinson‐White syndrome</topic><topic>clinical electrophysiology</topic><topic>reciprocating tachycardia</topic><topic>infranodal conduction delay</topic></subject><relatedItem type="host"><titleInfo><title>Pacing and Clinical Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0147-8389</identifier><identifier type="eISSN">1540-8159</identifier><identifier type="DOI">10.1111/(ISSN)1540-8159</identifier><identifier type="PublisherID">PACE</identifier><part><date>1983</date><detail type="volume"><caption>vol.</caption><number>6</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>702</start><end>707</end><total>6</total></extent></part></relatedItem><identifier type="istex">5D4CD6CEDEAC7A337A6ADFA9A891C40295417466</identifier><identifier type="DOI">10.1111/j.1540-8159.1983.tb05329.x</identifier><identifier type="ArticleID">PACE702</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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