Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan.
J Med Case Rep. 2023 Mar 27;17(1):111. doi: 10.1186/s13256-023-03865-6.
Wolff-Parkinson-White syndrome is characterized by a short PR interval (delta-wave), long QRS complex, and the appearance of paroxysmal supraventricular tachycardia. Patients with Wolff-Parkinson-White syndrome usually have one accessory pathway, whereas cases with multiple accessory pathways are rare. Persistent left superior vena cava is a vascular anomaly in which the vein drains into the right atrium through the coronary sinus at the junction of the left internal jugular and subclavian veins due to abnormal development of the left cardinal vein. The simultaneous presence of multiple accessory pathways and persistent left superior vena cava has not been reported before.
A 56-year-old Japanese man with a 5-year history of palpitations was referred for radiofrequency catheter ablation due to increased frequency of tachycardia episodes in the previous 2 months. Persistent left superior vena cava was confirmed by transthoracic echocardiography and computed tomography. An electrophysiological study revealed that the accessory pathways were located in the left lateral wall, anterolateral wall, and posteroseptal region. They were completely ablated with radiofrequency energy application.
We reported an extremely rare case of a patient with multiple accessory pathways and persistent left superior vena cava. Our case may suggest a potential embryological relationship between the multiple accessory pathways and persistent left superior vena cava.
沃-帕-怀综合征的特征为 PR 间期缩短（delta 波）、QRS 波群延长，以及阵发性室上性心动过速的出现。沃-帕-怀综合征患者通常存在一条附加旁路，而存在多条附加旁路的情况较为罕见。永存左上腔静脉是一种血管异常，由于左总静脉发育异常，导致静脉通过左颈内静脉和锁骨下静脉交界处的冠状窦流入右心房。同时存在多条附加旁路和永存左上腔静脉的情况以前尚未报道过。
一名 56 岁日本男性，心悸病史 5 年，因 2 个月前心动过速发作频率增加而被转诊行射频导管消融术。经胸超声心动图和计算机断层扫描证实存在永存左上腔静脉。电生理研究显示，附加旁路位于左侧外侧壁、前外侧壁和后间隔区域。使用射频能量完全消融了这些旁路。
我们报告了一例极其罕见的存在多条附加旁路和永存左上腔静脉的患者。我们的病例可能提示多条附加旁路和永存左上腔静脉之间存在潜在的胚胎学关系。
