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Europace 2019 Mar 18. Epub 2019 Mar 18.

Service de Cardiologie et Laboratoire d'Electrophysiologie Cardiaque, Centre Hospitalier Universitaire Trousseau et Université François Rabelais, Tours, France.

Asymptomatic arrhythmias are frequently encountered in clinical practice. Although studies specifically dedicated to these asymptomatic arrhythmias are lacking, many arrhythmias still require proper diagnostic and prognostic evaluation and treatment to avoid severe consequences, such as stroke or systemic emboli, heart failure, or sudden cardiac death. The present document reviews the evidence, where available, and attempts to reach a consensus, where evidence is insufficient or conflicting. Read More

Curr Cardiol Rev 2019 Mar 1. Epub 2019 Mar 1.

Pediatric Cardiology department of Puerta del Mar Universitary Hospital. Cadiz. Spain.

Asymptomatic VPE refers to the presence of this abnormal ECG pattern in the absence of any symptoms. The natural history in these patients is usually benign, and most children (60%) with VPE are usually asymptomatic. However, sudden cardiac death (SCD) has been reported to be the initial symptom in many patients too. Read More

HeartRhythm Case Rep 2019 Feb 20;5(2):109-111. Epub 2018 Nov 20.

Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.

J Arrhythm 2019 Feb 3;35(1):155-157. Epub 2018 Nov 3.

Department of Medicine University of California San Diego San Diego California.

A 16-year-old female with symptomatic Wolff-Parkinson-White (WPW) syndrome underwent catheter ablation of a left-sided lateral accessory pathway. The accessory pathway was eliminated with the first ablation lesion; however, the patient immediately developed complete heart block (CHB). At first, complete heart block was thought to be due to ablation of left atrial extension of the AV node, and pacemaker therapy was considered. Read More

Med Hypotheses 2019 Mar 2;124:56-59. Epub 2019 Feb 2.

Al Sabah Arrythmia Institute, Mount Sinai St. Luke's Hospital, New York, USA.

The atrioventricular node (AV) is considered the electrical connection between the atria and ventricles. There is an electrical pause between activation of the atria and the ventricles (PR segment), but to date the mechanism responsible for this interruption remains unclear. The present communication focuses on the hypothesis that magnetic field dynamics could provide the answer. Read More

Med Sci Monit 2019 Feb 19;25:1336-1341. Epub 2019 Feb 19.

Department of Cardiology, Medical University of Lublin, Lublin, Poland.

BACKGROUND Catheter ablation is a routine procedure in patients with WPW syndrome. Silent cerebral infarcts (SCI) detected in magnetic resonance imaging may be a complication of the ablation procedure, but it is well documented only in atrial fibrillation ablation. Ablation of left-sided accessory pathways (L-AP) has a similar target area, but WPW patients differ from those with atrial fibrillation, due to lower initial risk of cerebral embolic events. Read More

Heart Rhythm 2019 Feb 11. Epub 2019 Feb 11.

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. Electronic address:

Background: Fasciculoventricular fibers (FVFs) are responsible for 1%-5% of cases of asymptomatic preexcitation on the surface electrocardiogram (ECG). Unlike ventricular preexcitation seen in Wolff-Parkinson-White (WPW) syndrome, FVFs are not associated with sudden cardiac death from preexcited atrial fibrillation.

Objective: The purpose of this study was to identify surface ECG variables that differentiate FVFs from true WPW syndrome. Read More

Medicine (Baltimore) 2019 Feb;98(5):e14267

5th Department of Internal Medicine, 2nd Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy.

Rtionale: Left ventricular noncompaction (LVNC) is a genetic cardiomyopathy characterized by the presence of a thin compacted layer of myocardium and a spongy subendocardial layer with trabeculations and recesses. LVNC associated Wolf-Parkinson-White syndrome is very rare.

Patient Concerns: A 32-year-old male presented with short episodes of palpitations and a syncope 6 months before his hospitalization. Read More

Clin Schizophr Relat Psychoses 2019 Jan 3. Epub 2019 Jan 3.

1. Penn State Hershey Medical Center, Department of Psychiatry, Hershey, PA, USA.

Wolff-Parkinson-White syndrome (WPW) is a cardiac conduction abnormality characterized by ventricular contractions that appear sooner than the usual interval regulated by the atrioventricular (AV) node. It is commonly asymptomatic but in rare cases can lead to sudden cardiac death. Little is known about the cardiac effects of antipsychotics on patients with WPW. Read More

J Pak Med Assoc 2019 Jan;69(1):68-71

National Institute of Cardiovascular Diseases (NICVD), Karachi.

Objective: To review 10 years of clinical practice of cardiac electrophysiology study and radiofrequency catheter ablation in the treatment of supraventricular tachycardia.

Methods: The retrospective chart review was conducted at the National Institute of Cardiovascular Diseases, Karachi, and comprised records of all patients who underwent electrophysiological study and / or radiofrequency catheter ablation from January2007 to December 2016. SPSS 21 was used for data analysis. Read More

J Interv Card Electrophysiol 2019 Jan 3. Epub 2019 Jan 3.

Department of Heart and Vessels, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Viale Borri, 57, 21100, Varese, Italy.

Purpose: Radiofrequency (RF) catheter ablation of para-Hisian (P-H) and mid-septal (M-S) accessory pathways (APs) is a potentially harmful procedure due to their close location to the A-V node. Conversely, cryoablation (CA) appears safer in this setting. The aim of this study was to assess the efficacy and safety of CA of these APs using a specific protocol. Read More

Cardiol Young 2018 Dec 26:1-4. Epub 2018 Dec 26.

2Division of Cardiology, Department of Internal Medicine,The Armed Forces Capital Hospital,Seongnam,Republic of Korea.

We present a young soldier presenting with aborted sudden cardiac death, who was found to have concomitant hypertrophic cardiomyopathy and Wolff-Parkinson-White syndrome. Along with pathological haemodynamic features of hypertrophic cardiomyopathy, an easily-inducible re-entrant tachycardia was clearly documented in our patient. Given the fatal potential of supraventricular tachycardia in hypertrophic cardiomyopathy, we postulated that his tachyarrhythmia could potentially trigger the event. Read More

HeartRhythm Case Rep 2018 Dec 11;4(12):580-583. Epub 2018 Sep 11.

Division of Cardiology, Department of Internal Medicine, College of Medicine, Dankook University, Cheonan, South Korea.

Medicine (Baltimore) 2018 Dec;97(51):e13248

Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, PR China.

Rationale: The Wolff-Parkinson-White syndrome (WPW) is a benign heart disease with accessory pathways, which can result in cardiac arrhythmias. The purpose of this case report is to introduce a rare case of sudden cardiac death (SCD) with a mild myocardial bridge and a history of WPW.

Patient Concerns: A 25-year-old man with known WPW syndrome died at night while sleeping. Read More

J Am Heart Assoc 2018 Nov;7(21):e010617

8 Department of Pediatrics The Children's Hospital of Philadelphia Perelman School of Medicine University of Pennsylvania Philadelphia PA.

Pacing Clin Electrophysiol 2019 02 4;42(2):287-288. Epub 2019 Jan 4.

Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary.

We present the case of a 55-year-old female who presented for a short episode of palpitation and an electrocardiogram consistent with Wolff-Parkinson-White syndrome. She underwent an electrophysiological study showing that during incremental atrial pacing and extrastimulation the stimulus to QRS and QRS morphology stayed constant while the His to ventricular (HV) interval shortened. What can be the explanation for the constant QRS morphology, despite shortening HV during atrial pacing? Read More

Heart Views 2018 Apr-Jun;19(2):58-62

Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

The combination of Wolff-Parkinson-White (WPW) syndrome and rheumatic mitral stenosis (MS) is rare in clinical practice. The management of this condition primarily depends on the clinical picture. We describe a 26-year-old male patient with no significant previous medical history and who came for a routine medical assessment before entrance to a police academy service. Read More

HeartRhythm Case Rep 2018 Nov 4;4(11):519-522. Epub 2018 Aug 4.

Division of Pediatric Electrophysiology, Joe DiMaggio Children's Hospital, Hollywood, Florida.

Front Biosci (Elite Ed) 2019 01 1;11:102-108. Epub 2019 Jan 1.

Pediatric Nephrologist . Hospital Universitario Gregorio Marañon. Madrid, Spain.

Autoantibodies to beta-1 adrenergic receptor have been reported in adult patients with dilated cardiomyopathy (DCM). Removal of these antibodies has a positive hemodynamic effect. Our aim was to investigate whether these antibodies are present in children with DCM and explore the potential hemodynamic benefit of immunoadsorption (IA). Read More

J Atr Fibrillation 2018 Jun-Jul;11(1):2054. Epub 2018 Jun 30.

McGill University Health Centre, Montreal, Quebec, Canada.

A 43-year-old man presented after ventricular fibrillation cardiac arrest with evidence of pre-excited atrial fibrillation. Electrophysiology study with guideline-directed testing demonstrated a low risk accessory pathway effective refractory period, which became high-risk with isoproterenol infusion. This case represents a challenging scenario wherein a high-risk pathway may be misclassified using the currently indicated methods of risk stratification. Read More

Eur Heart J 2019 Mar;40(10):820-830

Department of Cardiology, Karolinska University Hospital, SE-171 76, Solna, Sweden.

Aims: Catheter ablation is considered the treatment of choice for many tachyarrhythmias, but convincing 'real-world' data on efficacy and safety are lacking. Using Swedish national registry data, the ablation spectrum, procedural characteristics, as well as ablation efficacy and reported adverse events are reported.

Methods And Results: Consecutive patients (≥18 years of age) undergoing catheter ablation in Sweden between 01 January 2006 and 31 December 2015 were included in the study. Read More

Indian Pacing Electrophysiol J 2019 Jan - Feb;19(1):34-38. Epub 2018 Nov 7.

Universidade Federal de São Paulo, Escola Paulista de Medicina, Hospital São Paulo, São Paulo, Brazil.

Introduction: Posteroseptal accessory pathways account for 34.5% of the total. Of these, 36% are located within the coronary sinus (CS). Read More

Rom J Anaesth Intensive Care 2018 Oct;25(2):131-147

Department of Anaesthesiology, 401 Military Hospital, Athens, Greece.

Patients with pre-excitation abnormalities are at a high risk for life-threatening perioperative arrhythmias. In Wolff-Parkinson-White syndrome, the anaesthetics used for invasive diagnostic testing/ablation, should not affect cardiac electrophysiology; propofol, sevoflurane, fentanyl, sufentanil, alfentanil are suitable. In non-ablative surgery, propofol, sevoflurane, isoflurane, fentanyl, alfentanil, sufentanil have been used safely. Read More

Singapore Med J 2018 10;59(10):558-559

Klinik Malaysia, Kluang, Johor, Malaysia.

ARYA Atheroscler 2018 May;14(3):139-141

Associate Professor, Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Trans-septal puncture (TSP) is a safe and effective method to approach left atrium and ventricle. Nowadays, cardiac electrophysiologists perform this procedure routinely to treat left-sided arrhythmias.

Case Report: A 45-year-old man was referred to our center due to Wolff-Parkinson-White (WPW) syndrome. Read More

J Geriatr Cardiol 2018 Sep;15(9):605-608

Department of Cardiology, No. 37 Hospital of PLA, Ya'an, Sichuan Province, China.

JACC Clin Electrophysiol 2018 Oct;4(10):1377-1378

Arrhythmia and Electrophysiology Research Center, Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Research and University Hospital, Rozzano (Milan), Italy.

JACC Clin Electrophysiol 2018 Oct 25;4(10):1271-1288. Epub 2018 Jul 25.

Cardiac Electrophysiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:

Ebstein's anomaly of the tricuspid valve is a relatively rare form of congenital heart disease that has long been a challenge to electrophysiologists and cardiac surgeons. In addition to the hemodynamic burden of the actual valve defect, Ebstein's patients must also contend with an extraordinarily high incidence of tachyarrhythmias, most of which can be attributed to accessory atrioventricular pathways (APs) located along the posterior and septal border of the tricuspid valve where the valve leaflets are most abnormal. It is the only congenital heart defect with such a dramatic predisposition toward APs. Read More

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618802870. Epub 2018 Sep 28.

Yale University, New Haven, CT, USA.

A 24-year-old man with history of unspecified arrhythmia presented with palpitations and chest pain. Initial electrocardiogram (ECG) revealed irregular tachycardia with varying QRS width: 150 to 200 beats per minute for narrow complexes and 300 beats per minute for wide complexes. Following cardioversion, ECG revealed sinus tachycardia with a preexcitation pattern of positive delta waves in the anterolateral leads and negative delta waves in inferior leads. Read More

J Cardiovasc Electrophysiol 2019 Jan 22;30(1):102-108. Epub 2018 Oct 22.

Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Introduction: The objective of the current study was to elucidate the effects of the accessory pathways (APs) on the left ventricular (LV) wall motion and radiofrequency catheter ablation (RFCA) on AP-related regional wall motion abnormality (RWMA) in patients with Wolff-Parkinson-White (WPW) syndrome.

Methods And Results: We included 348 consecutive patients (age, 37.6 ± 17. Read More

Turk Kardiyol Dern Ars 2018 10;46(6):488-493

Department of Cardiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.

A 31-year-old male patient presented with complaints of palpitations, dizziness, and recurrent episodes of syncope. A 12-lead electrocardiogram (ECG) revealed manifest ventricular preexcitation, which suggested Wolff Parkinson White syndrome. In addition, an incomplete right bundle branch block and a 3-mm ST segment elevation ending with inverted T-waves in V2 were consistent with coved-type (type 1) Brugada pattern. Read More

Turk Kardiyol Dern Ars 2018 09;46(6):433-434

Department of Cardiology, Marmara University Faculty of Medicine, İstanbul, Turkey.

Pediatr Cardiol 2019 Jan 10;40(1):194-197. Epub 2018 Sep 10.

Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289, Leipzig, Germany.

Ablation of accessory pathways (AP) is one of the most often performed procedures in pediatric electrophysiology. In pediatric patients these procedures are mostly performed in anaesthesia or sedation. In some of these patients who are referred for electrophysiologic (EP) study, we could observe disappearance of the preexcitation, i. Read More

Am J Cardiol 2018 Nov 3;122(9):1546-1550. Epub 2018 Aug 3.

Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China. Electronic address:

To assess the mid-term mortality and risk of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HC) and Wolff-Parkinson-White (WPW) syndrome, 40 patients with HC and WPW were enrolled in our center between 2010 and 2017. An age- and gender-matched comparison cohort of patients with HC without WPW (n = 160) was generated from the same center. The clinical profile and outcomes were assessed. Read More

Turk J Emerg Med 2018 Sep 13;18(3):131-133. Epub 2018 Apr 13.

Sisli Hamidiye Etfal Education and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common type of reentrant paroxysmal supraventricular tachycardia that occurs in the presence of dual AV nodal physiology. Wolff-Parkinson-White (WPW) syndrome is another type of supraventricular tachycardia characterized by short PR intervals, delta waves and wide QRS complexes on the surface electrocardiogram (ECG), reflecting atrioventricular pre-excitation. Uncommonly, AV nodal reentry and accessory pathways can coexist. Read More

J Electrocardiol 2018 Sep - Oct;51(5):792-797. Epub 2018 Jun 19.

Cardiology, CHU, Nancy, France.

Background: Due to high rates of ablation at the time of diagnostic EP study, follow-up of the natural history of untreated pre-excitation syndrome has become difficult. We present patients in which such data is available and study the effect of initial age on the evolution.

Methods: In this retrospective review, 126 patients, 47 aged ≤19 years, 79 aged more than>19 underwent 2 similar electrophysiological studies (EPS) within 1 to 25 years of one another (8. Read More

Indian J Anaesth 2018 Aug;62(8):641-643

Department of Anaesthesia, Seth GSMC, KEM Hospital, Mumbai, Maharashtra, India.

Intern Med 2019 Feb 24;58(3):401-404. Epub 2018 Aug 24.

Department of Cardiology and Clinical Examination, Oita University Faculty of Medicine, Japan.

We herein report a case of a 53-year-old man who survived cardiac arrest due to ventricular fibrillation (VF). When admitted to the hospital, his 12-lead electrocardiogram did not show Brugada-like ST elevation, early repolarization or delta-wave, in any leads. During the treatment of hypothermia, the manifestation of delta-wave was documented, which disappeared after the cessation of this treatment. Read More

Congenit Heart Dis 2018 Sep 21;13(5):671-677. Epub 2018 Aug 21.

Department of Child and Adolescent Health, Pediatrics I/III, Medical University of Innsbruck, Innsbruck, Austria.

Objective: In general, a mitochondrial disorder is diagnosed on the basis of symptom combinations and confirmed by genetic findings. However, patients carrying the m.3243A>G mutation in the mitochondrial tRNA leucine 1 (MT-TL1) do not always meet all the proposed criteria for the most frequently encountered mitochondrial syndrome "MELAS," an acronym for Mitochondrial Encephalomyopathy, Lactic Acidosis, and at least one Stroke-like episode. Read More

Herz 2018 Aug 20. Epub 2018 Aug 20.

Pasteur Institute of Tunis, University of Tunis El Manar and Genomics Platform, Tunis, Tunisia.

Objectives: Little is known about cardiac involvement in m.3243A>G variant carriers. Thus, this study aimed to assess type and frequency of cardiac disease in symptomatic and asymptomatic m. Read More

Cardiovasc Pathol 2018 Nov - Dec;37:1-4. Epub 2018 Jul 27.

Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan.

Myocardial bundles working as accessory pathways in Wolff-Parkinson-White (WPW) syndrome are generally tiny tissues, so elucidating the culprit histology of atrioventricular (AV) myocardial connections requires careful serial sectioning of the AV junction. We performed a postmortem examination of accessory AV myocardial connections in an 84-year-old man who died from pneumonia 20 years after surgical cryoablation for WPW syndrome. Three-dimensional reconstruction images of serial histologic sections revealed accessory AV connections between the atrial and ventricular myocardium in the vicinity of the cryoablation scar. Read More

Am J Med 2018 Dec 11;131(12):1456-1459. Epub 2018 Aug 11.

Division of Cardiovascular Medicine, Department of Internal Medicine, University of California (Davis) Medical Center, Sacramento.

J Cardiovasc Electrophysiol 2018 Nov 12;29(11):1581-1583. Epub 2018 Sep 12.

Department of Cardiac Electrophysiology, St. Vincent Medical Group, St. Vincent Hospital, Indianapolis, Indiana.

J Am Soc Echocardiogr 2018 Oct 31;31(10):1146-1150. Epub 2018 Jul 31.

Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio.

Background: Supraventricular tachycardia (SVT) is the most common sustained arrhythmia in children. Infants with SVT and ventricular preexcitation (Wolff-Parkinson-White syndrome) are known to have up to 30% prevalence of congenital heart disease (CHD). Infants without ventricular preexcitation who present with SVT at <1 year of age have a similar prevalence of CHD. Read More

Cardiol Young 2018 Nov 2;28(11):1375-1377. Epub 2018 Aug 2.

Department of Pediatric Cardiology,Ankara Child Health and Diseases, Hematology Oncology Training and Research Hospital,University of Health Sciences,Ankara,Turkey.

Steroids are used in the treatment of acute rheumatic fever with moderate-to-severe carditis. Corticosteroids have several cardiovascular side affects that are more common in adults than in children. Corticosteroid-related bradycardia is a rarely seen side effect. Read More

JACC Clin Electrophysiol 2018 Apr;4(4):456-458

Electrophysiology Program, Pennsylvania State University Heart and Vascular Institute, Penn State Health Children's Hospital, Penn State University College of Medicine, and The Milton S. Hershey Medical Center, Hershey, Pennsylvania. Electronic address:

JACC Clin Electrophysiol 2018 Apr;4(4):445-447

University of Western Ontario, Schulich School of Medicine, London, Ontario, Canada.

JACC Clin Electrophysiol 2018 Apr 15;4(4):433-444. Epub 2017 Nov 15.

Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.

Objectives: This study sought to characterize risk in children with Wolff-Parkinson-White (WPW) syndrome by comparing those who had experienced a life-threatening event (LTE) with a control population.

Background: Children with WPW syndrome are at risk of sudden death.

Methods: This retrospective multicenter pediatric study identified 912 subjects ≤21 years of age with WPW syndrome, using electrophysiology (EPS) studies. Read More