IngentaConnect Atrial Fibrillation with a Very Rapid Ventricular Response as the...

Authors: BREMBILLA-PERROT B.¹; HOURIEZ P.¹; BEURRIER D.¹; LOUIS P.¹; BOURSIER M.¹; KHALIFÉ K.²

Source: Pacing and Clinical Electrophysiology, Volume 26, Number 8, August 2003 , pp. 1769-1770(2)

Abstract:

BREMBILLA-PERROT, B.,et al.:Atrial Fibrillation with a Very Rapid Ventricular Response as the First Clinical Arrhythmia in a 76-Year-Old Man.

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 g of isoproterenol, atrial pacing was associated with a 1/1 conduction throught 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. (PACE 2003; 26:1769–1770)

Keywords: Wolff-Parkinson-White syndrome; sudden death

Document Type: Research article

DOI: 10.1046/j.1460-9592.2003.t01-1-00266.x

Affiliations: 1: Cardiology Department, CHU of Brabois, 54500 Vandoeuvre Les Nancy, France 2: Cardiology Department, Hôpital Bon Secours, 57000, Metz, France

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