Key Points
- To investigate the electrophysiological mechanisms and circuit pathways underlying reciprocating tachycardias in patients with Wolff-Parkinson-White syndrome.
- Performed intracardiac catheter recordings of the His bundle in patients with Wolff-Parkinson-White syndrome (N=3).
- Evaluated arrhythmia termination and circuit disruption through carotid sinus pressure and timed atrial electrical stimulation.
- Tachycardias were terminated in the first patient through carotid sinus pressure inducing atrioventricular nodal block or through precisely timed atrial pacing.
- Short paroxysms of atrial fibrillation developed in two patients, likely mediated by heightened atrial vulnerability.
- A third patient demonstrated three distinct QRS configurations indicating exclusive His bundle conduction, dual His-Kent bundle conduction, and concurrent His-Mahaim fiber conduction across multiple tachycardia circuits.
Structured PICO
PPopulation3 patients with reciprocating tachycardias and Wolff-Parkinson-White (WPW) syndrome
IInterventionHis bundle recordings via catheter technique
OOutcomeMechanisms of reciprocating tachycardias and conduction pathwayssurrogate
His bundle recordings provide detailed mechanistic insights into the complex conduction pathways and reciprocating tachycardias in patients with WPW syndrome.