Srpski arhiv za celokupno lekarstvo 2010 Volume 138, Issue 9-10, Pages: 639-642
https://doi.org/10.2298/SARH1010639B
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Pre-excitation pattern associated with accessory pathway related tachycardia: Case report
Burazor Mirko
Burazor Ivana
Mujović Nebojša
Introduction. Pre-excitation is based on an accessory conduction pathway
between the atrium and ventricle. The term Wolff- Parkinson-White (WPW)
syndrome is used for patients with the pre-excitation/WPW pattern associated
with AP-related tachycardia. Case Outline. We present a 52-year-old man with
severe palpitation, fatigue, lightheadedness and difficulty breathing. The
initial ECG showed tachyarrhythmia with heart rate between 240 and 300/min.
He was treated with antiarrhythmics (Digitalis, Verapamil, Lidocaine) with no
response. Then, the patient was treated with electrical cardioversion and was
referred to our Clinic for further evaluation with the diagnosis:
“Ventricular tachycardia”. During in-hospital stay, the previously
undiagnosed WPW pattern had been seen. Additional diagnostic tests confirmed
permanent pre-excitacion pattern (ECG Holter recording, exercises test). The
patient was referred to an electrophysiologist for further evaluation.
Mapping techniques provided an accurate assessment of the position of the
accessory pathway which was left lateral. The elimination of the accessory
pathway by radiofrequent catheter ablation is highly effective in termination
and elimination of tacchyarrhythmias. Conclusion. Symptomatic,
life-threatening arrhythmia, first considered as ventricular tachycardia,
reflected atrial fibrillation with ventricular pre-excitation over an
accessory pathway in a patient with previously undiagnosed WPW syndrome.
Keywords: pre-excitation, Wolff-Parkinson-White syndrome, atrial fibrillation
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