title: Concertina-like phenomenon in ventricular preexcitation due to spontaneous atrioventricular nodal Wenckebach periodicity.
abstract: 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.
authors.affiliation: Department of Medicine, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan, ROC.
authors.forename: M S
authors.initials: MS
authors.lastname: Wen
authors.forename: S J
authors.initials: SJ
authors.lastname: Yeh
authors.forename: C C
authors.initials: CC
authors.lastname: Wang
authors.forename: F C
authors.initials: FC
authors.lastname: Lin
authors.forename: D
authors.initials: D
authors.lastname: Wu
mesh_terms: 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