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Recurrent tachycardias due to an accessory pathway
Journal of Electrocardiology
|January 1, 1976
Summary
Normal electrocardiograms (ECGs) do not rule out accessory pathways. Accessory conduction pathways bypassing the atrioventricular node can cause pre-excitation, even with normal baseline ECG findings in patients with palpitations.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Patients with palpitations and syncope require thorough evaluation of the cardiac conduction system.
- His bundle electrogram (HBE) is a diagnostic tool to assess electrical conduction through the heart.
Observation:
- A 48-year-old female presented with a history of palpitations and syncopal episodes.
- Electrocardiogram (ECG) showed normal PR and QRS intervals; unpaced His electrogram was also normal.
Findings:
- During atrial pacing (110-180 beats/min), the AH and HV intervals remained unchanged.
- This suggests the presence of an accessory pathway bypassing the atrioventricular node.
Implications:
- Pre-excitation syndrome should be considered even with normal baseline ECGs.
- Accessory pathways can be present despite normal conduction intervals on standard electrocardiography.