Key result
Elimination of the accessory pathway in a patient with Wolff-Parkinson-White syndrome revealed J-point elevation, suggesting ventricular fibrillation was attributed to early repolarization syndrome.
Case Report (n=1)
In a patient with WPW syndrome presenting with VF, elimination of the accessory pathway unmasked early repolarization syndrome, suggesting ventricular preexcitation can modify J-point elevation.
May unmask early repolarization syndrome after accessory pathway ablation in WPW-VF; hypothesis-generating for preexcitation modifying J-point elevation.
A 23-year-old male with manifest Wolff-Parkinson-White syndrome presented with a first occurrence of ventricular fibrillation (VF). Initially, we anticipated the occurrence of atrial fibrillation, causing rapid antegrade conduction over the accessory pathway and, thus, resulting in hemodynamic deterioration. Electrophysiological study revealed that the atrioventricular accessory pathway was located at the mid-septum. After eliminating the pathway, a J-point elevation was revealed in the inferior and lateral leads. In addition, program ventricular stimulation induced VF, and the administration of isoproterenol suppressed VF. In our case, VF occurrence can be attributed to early repolarization syndrome and ventricular preexcitation-modified J-point elevation.
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Nauchi et al. (2019) conducted a case report in Wolff-Parkinson-White syndrome and ventricular fibrillation (n=1). Elimination of accessory pathway was evaluated on J-point elevation and VF induction. Elimination of the accessory pathway in a patient with Wolff-Parkinson-White syndrome revealed J-point elevation, suggesting ventricular fibrillation was attributed to early repolarization syndrome.
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