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KMID : 1011920100110010047
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International Journal of Arrhythmia
2010 Volume.11 No. 1 p.47 ~ p.49
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A case of pre-excitation syndrome with paradoxical accessory pathway conduction during exercise
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Jung Byung-Chun
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Abstract
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A 57-year-old man was referred to the cardiology clinic for evaluation of a wide QRS complex tachycadia on surface electrocardiogram (ECG). He had also suffered from an intermittent palpitation for about 30 years. On resting ECG, pre-excitation with intermittent ventricular conduction was observerd. During the exercise test, an interesting finding observed was that conduction over an accessory pathway (AP) was facilitated according to increment of heart rate whereas the conduction progressively deteriorated according to increment of heart rate in resting state. The underlying mechanism is regarded as supernormal conduction, or catecholamine related shortening of the refractory period of the accessory pathway. Additionally, the exercise test was useful to evaluate non-invasively the electophysiologic properties of AP in the Wolff-Parkinson-White (WPW) syndrome.
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KEYWORD
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WPW syndrome, exercise test
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