Abstract
A patient with Wolff-Parkinson-White syndrome type B developed 2:1 atrioventricular block resulting from the association of persistent right bundle-branch block with tachycardia-dependent (phase 3) left bundle-branch block. Electrophysiological studies disclosed the coexistence of a tachycardia-dependent (phase 3) block in the accessory pathway. This conduction disturbance was exposed, not by carotid sinus massage as in previous studies, but by pacing-induced prolongation of the interval between two consecutively conducted atrial impulses. Furthermore, the surface electrocardiogram showed, at different times, ventricular complexes resulting from: (1) exclusive atrioventricular conduction through the normal pathway without bundle-branch block; (2) predominant, or exclusive, atrioventricular conduction through a right-sided accessory pathway; (3) exclusive atrioventricular conduction through the normal pathway with right bundle-branch block; (4) exclusive conduction through the normal pathway, with left bundle branch-block; (5) fusion between (1) and (2); and finally, (6) fusion between (2) and (3). However, QRS complexes resulting from simultaneously occurring Wolf-Parkinson-White syndrome type B and left bundle-branch block could not be identified. Future electrophysiological investigations should re-evaluate the criteria used to differentiate true and false patterns of Wolff-Parkinson-White syndrome type B coexisting with left bundle-branch block.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 481-486 |
| Number of pages | 6 |
| Journal | British Heart Journal |
| Volume | 43 |
| Issue number | 4 |
| State | Published - 1980 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Wolff-Parkinson-White syndrome type B with tachycardia-dependent (phase 3) block in the accessory pathway and in left bundle-branch coexisting with rate-unrelated right bundle-branch block. / Mendoza, I.; Castellanos, Agustin; Sung, R. J.
In: British Heart Journal, Vol. 43, No. 4, 1980, p. 481-486.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Wolff-Parkinson-White syndrome type B with tachycardia-dependent (phase 3) block in the accessory pathway and in left bundle-branch coexisting with rate-unrelated right bundle-branch block
AU - Mendoza, I.
AU - Castellanos, Agustin
AU - Sung, R. J.
PY - 1980
Y1 - 1980
N2 - A patient with Wolff-Parkinson-White syndrome type B developed 2:1 atrioventricular block resulting from the association of persistent right bundle-branch block with tachycardia-dependent (phase 3) left bundle-branch block. Electrophysiological studies disclosed the coexistence of a tachycardia-dependent (phase 3) block in the accessory pathway. This conduction disturbance was exposed, not by carotid sinus massage as in previous studies, but by pacing-induced prolongation of the interval between two consecutively conducted atrial impulses. Furthermore, the surface electrocardiogram showed, at different times, ventricular complexes resulting from: (1) exclusive atrioventricular conduction through the normal pathway without bundle-branch block; (2) predominant, or exclusive, atrioventricular conduction through a right-sided accessory pathway; (3) exclusive atrioventricular conduction through the normal pathway with right bundle-branch block; (4) exclusive conduction through the normal pathway, with left bundle branch-block; (5) fusion between (1) and (2); and finally, (6) fusion between (2) and (3). However, QRS complexes resulting from simultaneously occurring Wolf-Parkinson-White syndrome type B and left bundle-branch block could not be identified. Future electrophysiological investigations should re-evaluate the criteria used to differentiate true and false patterns of Wolff-Parkinson-White syndrome type B coexisting with left bundle-branch block.
AB - A patient with Wolff-Parkinson-White syndrome type B developed 2:1 atrioventricular block resulting from the association of persistent right bundle-branch block with tachycardia-dependent (phase 3) left bundle-branch block. Electrophysiological studies disclosed the coexistence of a tachycardia-dependent (phase 3) block in the accessory pathway. This conduction disturbance was exposed, not by carotid sinus massage as in previous studies, but by pacing-induced prolongation of the interval between two consecutively conducted atrial impulses. Furthermore, the surface electrocardiogram showed, at different times, ventricular complexes resulting from: (1) exclusive atrioventricular conduction through the normal pathway without bundle-branch block; (2) predominant, or exclusive, atrioventricular conduction through a right-sided accessory pathway; (3) exclusive atrioventricular conduction through the normal pathway with right bundle-branch block; (4) exclusive conduction through the normal pathway, with left bundle branch-block; (5) fusion between (1) and (2); and finally, (6) fusion between (2) and (3). However, QRS complexes resulting from simultaneously occurring Wolf-Parkinson-White syndrome type B and left bundle-branch block could not be identified. Future electrophysiological investigations should re-evaluate the criteria used to differentiate true and false patterns of Wolff-Parkinson-White syndrome type B coexisting with left bundle-branch block.
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M3 - Article
VL - 43
SP - 481
EP - 486
JO - Heart
JF - Heart
SN - 1355-6037
IS - 4
ER -