Yolcu Mustafa
Department of Cardiology, Medicine Faculty, Yeni Yuzyil Universty, Istanbul, Turkey.
J Coll Physicians Surg Pak. 2019 Sep;29(9):886-887. doi: 10.29271/jcpsp.2019.09.886.
Wolff-Parkinson-White (WPW) syndrome causes paroxysmal supraventricular tachycardia in which short PR intervals and delta waves are seen in electrocardiography, which may cause sudden cardiac death. A 19-year female presented with increasing episodes of wide and narrow QRS complex tachycardia for the past 5 years. She had tricuspid atresia and Fontan Bjork operation in her past history. She was then diagnosed with narrow QRS complex tachycardia; and WPW syndrome was discovered when she returned to sinus rhythm. Ablation was performed from the coronary sinus ostium region via the left subclavian vein. Fontan Bjork procedure leading to accessory connections stemming from the surgery in the atrio-infundibular anastomosis may be one reason for WPW syndrome. In this case, since the ablation area was close to the Fontan anastomotic line, it could not be determined clearly whether WPW syndrome was secondary to Fontan anastomosis or it was congenital occult WPW syndrome, which became overt following Fontan surgery.
预激综合征(WPW)可引起阵发性室上性心动过速,心电图表现为PR间期缩短和δ波,可能导致心源性猝死。一名19岁女性在过去5年中出现宽窄QRS波群心动过速发作次数增加。她既往有三尖瓣闭锁和Fontan Bjork手术史。当时诊断为窄QRS波群心动过速;恢复窦性心律时发现预激综合征。通过左锁骨下静脉从冠状窦口区域进行消融。Fontan Bjork手术导致心房-漏斗部吻合处手术产生的附加连接可能是预激综合征的原因之一。在本例中,由于消融区域靠近Fontan吻合线,无法明确预激综合征是继发于Fontan吻合术还是先天性隐匿性预激综合征,后者在Fontan手术后变得明显。