Onset of atrial fibrillation during antidromic tachycardia: association with sudden cardiac arrest and ventricular fibrillation in a patient with Wolff-Parkinson-White syndrome. Am J Cardiol 1982 Aug;50(2):353-9
Date
08/01/1982Pubmed ID
7102563DOI
10.1016/0002-9149(82)90188-6Scopus ID
2-s2.0-0019981842 (requires institutional sign-in at Scopus site) 46 CitationsAbstract
Electrophysiologic evaluation in an 18 year old youth with the Wolff-Parkinson-White syndrome who had a sudden cardiac arrest while playing racquetball revealed two types of paroxysmal reciprocating tachycardia: (1) A normal QRS tachycardia with a short ventriculoatrial (V-A) interval fulfilled the criteria for reentry within the atrioventricular (A-V) node; and (2) a wide QRS tachycardia with a QRS configuration of maximal preexcitation was demonstrated to be the result of an antidromic mechanism. During laboratory study, the wide QRS tachycardia spontaneously degenerated into atrial fibrillation. In the basal state, the shortest R-R interval between preexcited QRS complexes was 270 ms, but after infusion of isoproterenol (1.6 microgram/min intravenously), the shortest R-R interval became 180 ms. Consequently, this electrophysiologic study suggested that evolution of antidromic reciprocating tachycardia into atrial fibrillation with a rapid ventricular response during exercise-induced catecholamine release may have been the mechanism for ventricular fibrillation in this patient.
Author List
Cosio FG, Benson DW Jr, Anderson RW, Hession WT, Pritzker MR, Kriett JM, Benditt DGMESH terms used to index this publication - Major topics in bold
AdolescentAtrial Fibrillation
Atrioventricular Node
Electrocardiography
Electrophysiology
Heart Arrest
Humans
Male
Physical Exertion
Tachycardia, Paroxysmal
Ventricular Fibrillation
Wolff-Parkinson-White Syndrome
