[A case of WPW syndrome with slow Kent documented by ATP injection].
A 46-year-old woman with chest tightness and palpitation at exercise was admitted to Sapporo Medical College Hospital for the evaluation of the ST-T changes on stress electrocardiogram. In this patient, PQ time was 0.14 second and pre-exitation was not clearly documented on electrocardiogram at rest. Bolus injection of 10 mg of adenosine-5'-triphosphate (ATP) demonstrated deltawave through the elongation of antegrade conduction of atrio-ventricular (AV) node. Electrophysiological study also showed left lateral accessory pathway with slow antegrade conduction, slow Kent. Stress 201-T1 myocardial scintigraphy using bicycle ergometer did not show the existence of ischemic region in spite of the ST-T changes on electrocardiogram. In this case, it seemed that a false positive ST-T changes might be caused by ventricular pre-exitation through slow Kent fiber. From these findings, it was suggested that the transient interruption on conduction through AV node by ATP bolus injection may be a useful diagnostic method in borderline pre-exitation syndrome.
Tsuchihashi
K
K
Endo
A
A
Hikita
N
N
Noto
T
T
Kamei
F
F
Nakata
T
T
Iwakura
M
M
Yonekura
S
S
Hashimoto
A
A
Tanaka
S
S
D000255:Adenosine Triphosphate / Q000008:administration & dosage; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis*
D000255:Adenosine Triphosphate