Iatrogenic ventricular fibrillation in Wolff-Parkinson-White syndrome

Autores da FMUP

• Manuel Belchior Campelo

  Autor

Participantes de fora da FMUP

• Nunes, Alzira
• Lebreiro, Ana
• Adao, Luis
• Maciel, Maria Julia

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Wolff-Parkinson-White (WPW) syndrome is the most common manifestation of ven-tricular pre-excitation syndrome and is mostly found in individuals with no structural heart disease. Although the risk of malignant arrhythmias is low, sudden cardiac death (SCD) as the first clinical manifestation of WPW syndrome is well documented, and atrial fibrillation (AF) with a rapid ventricular response is the main mechanism involved. Unfortunately, the signs of pre-excitation and arrhythmias are sometimes under-diagnosed and under-treated. We describe the case of a 31-year-old man who was admitted with an irregular wide complex tachycardia consistent with pre-excited AF, which was not promptly diagnosed, and who developed ventric-ular fibrillation (VF) after administration of atrioventricular (AV) nodal blockers, as a primary manifestation of WPW syndrome. Blocking the AV node in patients with pre-excited AF may increase the ventricular rate and potentially result in hemodynamic instability. Among patients with WPW syndrome who survive an episode of SCD, catheter ablation of the accessory pathway is the treatment of choice.(c) 2022 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espan tilde a, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Keywords

• Wolff-Parkinson-White; Accessory pathway; Pre-excited atrial fibrillation; Ventricular fibrillation; Atrioventricular nodal blockers; Catheter ablation