Key result
Rapid atrial or ventricular pacing transiently inhibits antegrade accessory pathway conduction in WPW syndrome.
Case Report (n=1)
No
Demonstrates that overdrive suppression of conduction can occur in accessory pathways in Wolff-Parkinson-White syndrome following rapid pacing or tachycardia.
Should not yet change practice in WPW; leaves open whether overdrive suppression affects accessory pathway management.
In a patient with Wolff-Parkinson-White syndrome whose accessory pathway was primarily capable of bidirectional conduction, antegrade conduction over the accessory pathway was transiently inhibited after rapid atrial or ventricular pacing or after spontaneous termination of atrioventricular reentrant tachycardia. Pacing rate and duration of tachycardia were related to the duration of the suppression of preexcitation, while the coupling interval of the first sinus beat to the last driven or tachycardia beat was irrelevant to the phenomenon. Thus, overdrive suppression of conduction may be the most likely mechanism of this phenomenon.
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Fukui et al. (2000) conducted a case report in Wolff-Parkinson-White syndrome (n=1). Rapid atrial or ventricular pacing (overdrive pacing) vs. Baseline state was evaluated on Antegrade conduction over the accessory pathway (preexcitation). Rapid atrial or ventricular pacing transiently inhibited antegrade conduction over the accessory pathway in a patient with Wolff-Parkinson-White syndrome.
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