Case Report (n=1)
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Spontaneous variations in AV nodal conduction during atrial pacing can explain QRS variability and benign clinical courses in some patients with WPW syndrome.
Atrial pacing in a patient with a Wolff-Parkinson-White syndrome pattern showed unusual variability in AV nodal conduction time. Changes in the AV nodal conduction time occurred predominantly at paced rates in excess of 100/min and consisted of abrupt or gradual decreases in the AH interval. Such decreases resulted in unexpected normalization of the QRS pattern. In addition, pacing also revealed evidence of block in the accessory pathway. Such changes in atrioventricular conduction may account for the known variability of the QRS pattern in patients with the WPW syndrome. Further, they may also explain the benign clinical course in this patient.
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Parameswaran et al. (1976) conducted a case report in Wolff-Parkinson-White syndrome (n=1). Atrial pacing was evaluated on AV nodal conduction time and QRS pattern.
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