Concertina-like phenomenon in ventricular preexcitation due to spontaneous atrioventricular nodal Wenckebach periodicity.
Electrophysiologic study and radiofrequency ablation therapy were performed in a 28-year-old male patient with the Wolff-Parkinson-White syndrome and electrocardiographic manifestation of concertina phenomenon. His bundle recordings showed a sinus cycle length of 720 = ms with a cyclic variation of QRS morphologies of every 3 beats and an antidromic atrial echo following the last fully preexcited QRS complex. After successful radiofrequency ablation of a left posterior accessory pathway, spontaneous 3:2 atrioventricular nodal Wenckebach periodicity was noted and the mechanism of the concertina phenomenon was unraveled.
Wen
M S
MS
Department of Medicine, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, ROC.
Yeh
S J
SJ
Wang
C C
CC
Lin
F C
FC
Wu
D
D
D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D004562:Electrocardiography; D006327:Heart Block / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery