Related Experiment Videos
Louise Egedahl Lind1, Andi Eie Albertsen1
1Hjertesygdomme, Regionshospitalet Viborg.
Insights
A case report details a patient with permanent atrial fibrillation misdiagnosed initially. Successful ablation of an accessory pathway resolved pre-excited atrial fibrillation, a manifestation of Wolff-Parkinson-White syndrome.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia.
- Wolff-Parkinson-White (WPW) syndrome can present with rapid ventricular rates during AF.
Observation:
- A 63-year-old male with persistent AF presented with dyspnea and pre-excited atrial fibrillation on ECG.
- Initial treatments with digoxin and amiodarone were unsuccessful.
- Multiple direct current cardioversions (DC-conversions) failed to maintain sinus rhythm.
Findings:
- The patient was diagnosed with Wolff-Parkinson-White syndrome.
- An accessory pathway was identified and successfully ablated at a specialized center.
- Ablation resolved the pre-excited atrial fibrillation and associated symptoms.
Implications:
- This case highlights the importance of recognizing pre-excited atrial fibrillation in WPW syndrome.
- Accurate diagnosis and targeted therapy, such as ablation, are crucial for managing complex arrhythmias.
- Early identification of accessory pathways can prevent ineffective treatments and improve patient outcomes.
Abstract:
A 63-year-old mand with permanent atrial fibrillation through five years presents to the emergency room with dyspnea and an ECG showing pre-excited afib. The ECG was initially perceived as afib with bundle branch block and treated with digoxin. After that, treatment with amiodaron was given; also without success. After DC-conversion, multiple times and relapse, the patient was transferred to a highly specialised hospital, and an accessory pathway was performed ablated. This is a case report of a patient who had permanent atrial fibrillation and whose initial presentation of Wolff-Parkinson White syndrome was pre-excited atrial fibrillation.