March 1, 1972Circulation
Disabling Supraventricular Tachycardia of Wolff-Parkinson-White Syndrome (Type A) Controlled by Surgical A-V Block and a Demand Pacemaker after Epicardial Mapping Studies
Why the study?
Does surgical A-V block and demand pacemaker insertion prevent supraventricular tachycardia in a patient with W-P-W syndrome (type A) when primary pathway interruption fails?
Key Points
- The aim is to explore the treatment of disabling supraventricular tachycardia associated with Wolff-Parkinson-White syndrome type A using surgical intervention.
- Used epicardial mapping to locate the aberrant pathway before surgical intervention.
- Performed surgical A-V block and inserted a demand pacemaker.
- Monitored post-operative electrocardiograms for conduction patterns.
- Post-surgery, the patient was free of supraventricular tachycardia.
- Postoperative electrocardiograms showed no antegrade or retrograde A-V conduction.
- Analysis indicated the accessory pathway was likely located adjacent to or left of the atrioventricular septum.
Structured PICO
Does surgical A-V block and demand pacemaker insertion prevent supraventricular tachycardia in a patient with W-P-W syndrome (type A) when primary pathway interruption fails?
P
Population
A patient with Wolff-Parkinson-White (W-P-W) syndrome (type A) and disabling supraventricular tachycardia
I
Intervention
Epicardial mapping followed by surgical A-V block and insertion of an epicardial demand pacemaker
O
Outcome
Freedom from supraventricular tachycardia
Surgical A-V block combined with a demand pacemaker successfully controlled disabling supraventricular tachycardia in a patient with W-P-W syndrome type A after failed primary interruption of the accessory pathway.
Authors
Discussion
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Implication
May support AV block plus pacing for refractory WPW after failed pathway interruption; leaves open need for controlled studies.
Cite This Study
Dunaway et al. (1972) studied this question.