Wolff-Parkinson-White syndrome. Problems in evaluation of multiple accessory pathways and surgical therapy
| Autor: | Jacques Aigueperse, Philippe Coumel, Alexandre Fabiato, Robert Slama, Marc Waynberger, Yves Bouvrain |
|---|---|
| Rok vydání: | 1972 |
| Předmět: |
Tachycardia
Adult Stimulation QRS complex Electrocardiography Heart Conduction System Physiology (medical) James Fibers medicine Deformity Humans Heart Atria Kent Bundle Mahaim fiber Tachycardia Paroxysmal Sinoatrial Node medicine.diagnostic_test business.industry Anatomy Syndrome Electric Stimulation Heart Block Wolff-Parkinson-White Syndrome medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Circulation. 45(6) |
| ISSN: | 0009-7322 |
| Popis: | Total atrioventricular bypass (Kent bundle) does not explain all the findings in some cases of Wolff-Parkinson-White (W-P-W) syndrome. Two cases are reported in which two accessory pathways, set in series or in parallel, could be demonstrated. In case 1, a short P-R interval, gap phenomenon, and presence of delta wave with either a short or long P-R interval suggested the hypothesis of an atrio-His accessory path (James fibers). The presence of a type-B delta wave during His stimulation demonstrated the takeoff of another bypass (Mahaim fibers) below or at the point of stimulation. The His-ventricle accessory path had a supernormal phase of conduction during either atrial or His stimulation. In case 2, the rapid spread of the impulse to the His bundle (P-H 65 msec) was responsible for a normal H-R interval (35 msec) during either reciprocating tachycardia or normal sinus rhythm wtih a nonwidened QRS and minimal W-P-W deformity (partial cancellation of the delta wave). During reciprocating tachycardia, alternatively short and long P'-H intervals with constant H-R (His bundle) and R-P' (Kent bundle) were due to alternate antegrade atrio-His conduction through the atrionodal nodal bypass (James fibers) and the A-V node. Surgical findings confirmed the existence of a left bundle of Kent. The division of the His bundle resulted in a maximal W-P-W deformity (type A) and abolished the reciprocating tachycardia. |
| Databáze: | OpenAIRE |
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