Key result
A patient with Wolff-Parkinson-White syndrome developed permanent anterograde block in the accessory pathway, leading to loss of pre-excitation but ensuing incessant circus tachycardia.
Case Report (n=1)
This case demonstrates that retrogradely conducting pathways causing supraventricular tachycardia may previously have had overt pre-excitation that was lost due to anterograde block.
May cause incessant SVT via intact retrograde conduction after anterograde block; leaves open contribution of concealed pathways to common SVT.
A case is reported, the sixth in the literature, in which permanent anterograde block occurred in the accessory pathway of a patient with Wolff-Parkinson-White syndrome, so that pre-excitation no longer occurred. Retrograde conduction remained intact and the patient developed incessant tachycardia with ventriculo-atrial conduction occurring over the accessory pathway. Retrogradely conducting pathways are a common cause of supraventricular tachycardia and this case raises the possibility that many of them may previously have had overt pre-excitation.
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Miller et al. (1981) conducted a case report in Wolff-Parkinson-White syndrome (n=1). Permanent anterograde block in the accessory pathway was evaluated on Development of incessant tachycardia. A patient with Wolff-Parkinson-White syndrome developed permanent anterograde block in the accessory pathway, leading to loss of pre-excitation but ensuing incessant circus tachycardia.
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