Catecholamine challenge unmasking high-risk features in the Wolff-Parkinson-White syndrome.
Risk stratification in patients with Wolff-Parkinson-White (WPW) syndrome is an important clinical problem given a small, but significant risk of sudden death. It has been widely accepted that intermittent pre-excitation is associated with a low-risk pathway. We report a case of WPW with intermittent pre-excitation at baseline, but with marked sensitivity to adrenergic stimulation, revealed by exercise and isoproterenol administration.
Aleong
Ryan G
RG
Massachusetts General Hospital, Cardiac Arrhythmia Service, GRB 109, 55 Fruit Street, Boston, MA 02114, USA.
Singh
Sheldon M
SM
Levinson
John R
JR
Milan
David J
DJ
D000318:Adrenergic beta-Agonists; D002395:Catecholamines; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D004562:Electrocardiography / Q000187:drug effects*; D005080:Exercise Test; D006801:Humans; D007545:Isoproterenol; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis*
D000318:Adrenergic beta-Agonists; D002395:Catecholamines; D007545:Isoproterenol