title: Supraventricular tachycardia in a patient with Lown-Ganong-Levine syndrome associated with apical hypertrophic cardiomyopathy.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Saga Medical School, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hayano
authors.forename: Y
authors.initials: Y
authors.lastname: Imamura
authors.forename: M
authors.initials: M
authors.lastname: Tsuruta
authors.forename: J
authors.initials: J
authors.lastname: Inoue
authors.forename: H
authors.initials: H
authors.lastname: Nakashima
authors.forename: K
authors.initials: K
authors.lastname: Fukuyama
authors.forename: Y
authors.initials: Y
authors.lastname: Eguchi
authors.forename: S
authors.initials: S
authors.lastname: Tsuji
authors.forename: S
authors.initials: S
authors.lastname: Matsuo
authors.forename: K
authors.initials: K
authors.lastname: Yano
mesh_terms: 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