The Wolff-Parkinson-White syndrome: problems in evaluation and surgical therapy.
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Two patients with WPW syndrome underwent surgery to ablate accessory conduction pathways and the areas of early right ventricular depolarization failed in both cases to normalize the electrocardiogram.Abstract:
Two patients with WPW syndrome underwent surgery to ablate accessory conduction pathways. Endocardial and epicardial mapping in both patients had indicated an area of early right ventricular depolarization. Surgical transection of the areas of early depolarization failed in both cases to normalize the electrocardiogram. In the first patient, additional resection in the area of the A-V node failed to produce heart block and the ECG remained abnormal. However, the paroxysmal tachycardia ceased, and she has remained asymptomatic and active 12 months after surgery. In the second patient, as the A-V node was about to be sectioned, pressure and procaine near the A-V node caused the ECG to normalize transiently and after resection permanently. Microscopic study of this tissue showed "P cells." Postoperatively the patient demonstrated normal A-V nodal function. He was discharged with a normal ECG but expired soon after discharge. Postmortem examination of the heart demonstrated the A-V node and bundle of His plus the location of the resection adjacent to the bundle of His. These two cases illustrate disparities between electrophysiologic mapping and actual site of the accessory conduction pathway. In one of the cases an accessory bundle was demonstrated histologically.read more
Citations
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Catheter Technique for Closed-Chest Ablation of the Atrioventricular Conduction System
John J. Gallagher,Robert H. Svenson,Jack H. Kasell,Lawrence D. German,Gust H. Bardy,Archer Broughton,Giuseppe Critelli +6 more
TL;DR: This report describes a catheter technique for ablating the His bundle and its application in nine patients with recurrent supraventricular tachycardia that was unresponsive to medical management and all patients have remained free of arrhythmia, without medication, for follow-up periods of two to six months.
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Cryothermal ablation: mechanism of tissue injury and current experience in the treatment of tachyarrhythmias.
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Wolff-Parkinson-White syndrome. The problem, evaluation, and surgical correction.
TL;DR: It is felt that in selected patients, surgical correction of the WPW syndrome is entirely feasible, and can be accomplished in the majority of patients in whom free wall A-V connections are present.
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Control of Tachyarrhythmias Associated with Wolff-Parkinson-White Syndrome by Amiodarone Hydrochloride
TL;DR: Amiodarone hydrochloride proved to be highly effective in preventing and treating arrhythias of the Wolff-Parkinson-White (WPW) syndrome in 11 patients with WPW conduction and recurrent tachyarrhythmias.
References
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Journal ArticleDOI
The Role of Premature Beats in the Initiation and the Termination of Supraventricular Tachycardia in the Wolff-Parkinson-White Syndrome
TL;DR: In four patients with WPW syndrome atrial and ventricular premature beats were induced and the changes in form of the ventricular and atrial complexes were studied, results suggest that a circus movement involving the atria, the normal atrioventricular conduction system and the Kent bundle is present.
Journal ArticleDOI
Successful Surgical Interruption of the Bundle of Kent in a Patient with Wolff-Parkinson-White Syndrome
Frederick R. Cobb,Sarah D. Blumenschein,Will C. Sealy,John P. Boineau,Galen S. Wagner,Andrew G. Wallace +5 more
TL;DR: Surgical transection of the atrioventricular junction at that point abolished the electrocardiographic features of WPW and the recurrent tachycardia, and five months after surgery the signs and symptoms of congestive heart failure have subsided, and the patient has returned to work.
Journal ArticleDOI
The potential variations of the thorax and the esophagus in anomalous atrioventricular excitation (Wolff-Parkinson-White syndrome)☆
Journal ArticleDOI
Epicardial Excitation of the Ventricles in a Patient with Wolff-Parkinson-White Syndrome (Type B)
D. Durrer,J. P. Roos +1 more
TL;DR: Epicardial excitation was explored by means of an exploring electrode during operation on a patient with a large atrial septal defect of the secundum type, whose ECG indicated a Wolff-Parkinson-White syndrome of type B.
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Comparative Ultrastructure of the Sinus Node in Man and Dog
TL;DR: Correlation of the electron microscopic appearance of the sinus node with that based on light microscopy is discussed, and some of the possible functional significances of the fine structure are considered.
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