Supraventricular tachycardia in a patient with Lown-Ganong-Levine syndrome associated with apical hypertrophic cardiomyopathy.
Electrophysiologic study of a 55-year-old patient with Lown-Ganong-Levine syndrome associated with apical hypertrophic cardiomyopathy is reported. The patient had a history of recurrent attacks of tachyarrhythmia and his electrocardiogram showed a short P-R interval (0.10 sec) with narrow QRS complex and left ventricular hypertrophy with giant negative T waves. His cineangiogram showed severe apical hypertrophy. An electrophysiologic study was performed. The results of programmed atrial pacing show the existence of the dual A-V nodal pathways. The A-H interval at rapid atrial pacing increased maximally by 103 msec. Atrial stimulation could depolarize parts of the atrium without altering the supraventricular tachycardia. These findings suggested that preferential rapidly conducting A-V nodal and intranodal reentry are the responsible mechanisms in this reciprocating tachycardia. We conclude that the short P-R interval was due to intranodal reentry through the dual A-V nodal pathways. To our knowledge, a case of Lown-Ganong-Levine syndrome with apical hypertrophic cardiomyopathy has not been previously described in the literature.
Hayano
M
M
Department of Internal Medicine, Saga Medical School, Japan.
Imamura
Y
Y
Tsuruta
M
M
Inoue
J
J
Nakashima
H
H
Fukuyama
K
K
Eguchi
Y
Y
Tsuji
S
S
Matsuo
S
S
Yano
K
K
D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008151:Lown-Ganong-Levine Syndrome / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D011226:Pre-Excitation Syndromes / Q000150:complications*; D013617:Tachycardia, Supraventricular / Q000150:complications* / Q000503:physiopathology