Concealed pre-excitation causing paroxysmal reciprocating atrioventricular tachycardia in infancy. 1978

K A Hallidie-Smith, and D Krikler, and A Mithchell

We report 3 infants with Wolff-Parkinson-White (WPW) syndrome who presented with life-threatening paroxysmal reciprocating atrioventricular tachycardia in their first month of life. The diagnosis was confirmed by electrophysiological studies at ages 2--4 years, but the characteristic ECG of pre-excitation has not been shown in one patient and was first recorded at 2 and 3 years in the other two. In 2 patients the tachycardia proved refractory to treatment with digoxin alone but responded to the addition of propranalol or verapamil. One of these infants was converted to sinus rhythm by DC countershock, giving time to reconsider his treatment with drugs. Digoxin is a well-tried treatment acting by slowing AV conduction and interrupting the re-entry circuit. However, it may act more slowly than other agents that act on the AV node--such as intravenous verapamil. Our patients illustrate the value of long follow-up as the diagnosis of WPW syndrome could not be made in infancy. Many infants who present with paroxysmal supraventricular tachycardia in infancy may have an inapparent bypass and be examples of the WPW syndrome.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001283 Atrioventricular Node A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. AV Node,A-V Node,Atrio-Ventricular Node,A V Node,A-V Nodes,AV Nodes,Atrio Ventricular Node,Atrio-Ventricular Nodes,Atrioventricular Nodes,Node, A-V,Node, AV,Node, Atrio-Ventricular,Node, Atrioventricular,Nodes, A-V,Nodes, AV,Nodes, Atrio-Ventricular,Nodes, Atrioventricular
D013614 Tachycardia, Paroxysmal Abnormally rapid heartbeats with sudden onset and cessation. Paroxysmal Reciprocal Tachycardia,Paroxysmal Reciprocal Tachycardias,Paroxysmal Tachycardia,Paroxysmal Tachycardias,Reciprocal Tachycardia, Paroxysmal,Reciprocal Tachycardias, Paroxysmal,Tachycardia, Paroxysmal Reciprocal,Tachycardias, Paroxysmal,Tachycardias, Paroxysmal Reciprocal
D014927 Wolff-Parkinson-White Syndrome A form of ventricular pre-excitation characterized by a short PR interval and a long QRS interval with a delta wave. In this syndrome, atrial impulses are abnormally conducted to the HEART VENTRICLES via an ACCESSORY CONDUCTING PATHWAY that is located between the wall of the right or left atria and the ventricles, also known as a BUNDLE OF KENT. The inherited form can be caused by mutation of PRKAG2 gene encoding a gamma-2 regulatory subunit of AMP-activated protein kinase. WPW Syndrome,Anomalous Ventricular Excitation Syndrome,Auriculoventricular Accessory Pathway Syndrome,False Bundle-Branch Block Syndrome,Ventricular Pre-Excitation with Arrhythmia,Wolf-Parkinson-White Syndrome,Syndrome, WPW,Syndrome, Wolf-Parkinson-White,Syndrome, Wolff-Parkinson-White,Wolf Parkinson White Syndrome,Wolff Parkinson White Syndrome

Related Publications

K A Hallidie-Smith, and D Krikler, and A Mithchell
January 1990, International journal of cardiology,
K A Hallidie-Smith, and D Krikler, and A Mithchell
September 1981, British heart journal,
K A Hallidie-Smith, and D Krikler, and A Mithchell
January 1977, European journal of cardiology,
K A Hallidie-Smith, and D Krikler, and A Mithchell
October 1969, Diseases of the chest,
K A Hallidie-Smith, and D Krikler, and A Mithchell
March 2016, Cardiac electrophysiology clinics,
K A Hallidie-Smith, and D Krikler, and A Mithchell
October 1974, Journal of electrocardiology,
K A Hallidie-Smith, and D Krikler, and A Mithchell
November 1975, The American journal of cardiology,
K A Hallidie-Smith, and D Krikler, and A Mithchell
November 2006, Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology,
Copied contents to your clipboard!