title: [1:1 atrial flutter in an elderly patient: one of the methods of discovering Wolff-Parkinson-White syndrome. Apropos of a case in an adult].
abstract: Atrial flutter with 1:1 atrioventricular conduction giving rise to a ventricular rhythm of 240/min in an 80 year old man was the first sign of the Wolff-Parkinson-White syndrome; all previous electrocardiogrammes had shown no evidence of pre-excitation. It was only on the fifth day of hospitalisation that the ECG showed a short PR interval with a delta wave. This case illustrates that: --all supraventricular arrhythmias with abnormally high ventricular rates (over 220/min in adults) should alert to the possibility of an accessory atrioventricular pathway; --rapid atrioventricular conduction may be the first sign of an accessory pathway; --the differential diagnosis lies between an accessory atrioventricular pathway and an atriohisian tract; --digitalis, which may shorten the refractory period of the accessory pathway, is contraindicated in patients with a Kent bundle.
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000209:etiology*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications* / Q000175:diagnosis
vernacular_title: Flutter auriculaire 1:1 chez un vieillard: une des modalités de découverte d'un syndrome de Wolff-Parkinson-White. A propos d'une observation chez un adulte.