Atrio-ventricular block on Wolff Parkinson White’s syndrome: a rare association.
Keywords:
Atrioventricular block; Pre-excitation syndromesAbstract
Complete atrioventricular block (AV block) associated with an accessory pathway is a rare phenomenon. We report the case of a third degree AV block paired with a Wolff Parkinson White (WPW) syndrome in a 91-year-old patient. The electrocardiogram (ECG) on admission showed a Mobitz type II AV block alternating with a third degree block on a wide-QRS ventricular rhythm beating at 35 cycles per minute. The patient urgently underwent the implantation of a single-lead pacemaker. The post-implantation ECG revealed a Kent accessory pathway on the left posteroseptal site. The existence of a complete AV block in the presence of an accessory pathway implies a more or less permanent blockage of atrial depolarization, both through the normal conduction tissue and the accessory pathway.
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References
Takagi Y, Watanabe I, Masaki R, Okumura Y, Yamada T, Wakita R et al. Complete AV block developing in a patient with manifest ventricular preexcitation. Int Heart J 2005;46(4):729-35.
Chaib A, Bouzelmat H, Boulaamayel S, Kheyi J, Moustaghfir A. Une pré-excitation en bloc. Presse Med 2014;43:480-482.
Erdogan O. A rare coexistence of complete atrioventricular block and preexcitation in an elderly symptomatic patient. J Cardiovasc Med 2008;9(7):729-732.
Mossuti E, Elia F, Martello G, Brancati B. Coexistence of complete infra-Hisian block, WPW syndrome and Mobitz type II Kent Bundle block. Pacing Clin Electrophysiol 1990;13:1563-6.
Liu S, Olsson S.B, Hertervig E, Kongstad O, Yuan S. Atrioventricular conduction: a determinant for the manifestation of ventricular preexcitation in patients with Wolff Parkinson White syndrome. Clinical Physiology 2001;21:534-540.
Erickson C, Yetman A T, Jones C S, Duncan W T. Late Onset of Accessory Pathway Conduction in a Patient with Complete AV Block. Pacing and Clinical Electrophysiology 2000;23(2):280-282.
Dinckal M H, Davutoglu V, Bayata S. Masked Complete Atrioventricular Block in a Patient with Ventricular Preexcitation. J Interv Card Electrophysiol 2004;11:33-35.
Singh B, Sudan D, Kaul U. Transient complete atrioventricular block following radiofrequency ablation of left free wall accessory pathway. J Inter Card Electrophysiol 1998;2:305-307.
