Abstract
Antidromic circus movement tachycardia was documented in 36 of 345 consecutive patients with Wolff-Parkinson-White syndrome undergoing detailed electrophysiologic evaluation. Twenty-six patients were men and 10 were women (mean age ± standard deviation 26 ± 12 years [range 12 to 45]). Multiple accessory pathways were identified in 12 of these 36 patients (33%). Ten of the patients (67%) with clinically documented antidromic tachycardia had multiple accessory pathways. Dizziness and syncope occurred in 61 and 50% of patients with antidromic circus movement tachycardia. Six patients had clinical documentation of atrial fibrillation, and 4 patients (11%) were resuscitated from ventricular fibrillation. In the 36 patients, 56 distinct antidromic tachycardia were recorded and several different pathways were observed. Orthodromic tachycardia was the most frequently associated arrhythmia (72%). Dual atrioventricular nodal pathways were present in 12 patients (33%); however, atrioventricular nodal tachycardia could be initiated in only 2 of them. Interruption of the accessory pathway was successfully performed in all 20 patients undergoing surgery.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Wellens HJJ: Electrical Stimulation of the Heart in the Study and Treatment of Tachycardias. University Park Press, Baltimore, 74–121, 1971.
Gallagher JJ, Pritchett ELC, Sealy WC, Kasell J, Wallace AG: The pre-excitation syndromes. Prog Cardiovasc Dis 20: 285–327, 1978.
Cosio FG, Benson DW, Anderson RW, Hession WT, Pritzker MR, Kriett JM, Benditt DG: Onset of atrial fibrillation during antidromic tachycardia: association with sudden cardiac arrest and ventricular fibrillation in a patient with Wolff-Parkinson-White syndrome. Am J Cardiol 50: 353–359, 1982.
Heddle WF, Brugada P, Wellens HJJ: Multiple circus movement tachycardias with multiple accessory pathways. J Am Coll Cardiol 4: 68–175, 1984.
Chung EK, Walsh TJ, Massie E: Wolff-Parkinson-White syndrome. Am Heart J 69: 116–133, 1965.
Wellens HJJ, Durrer D: Patterns of ventriculo-atrial conduction in the Wolff-Parkinson-White syndrome. Circulation 49: 22–41, 1974.
Fontaine G, Frank R, Coutte R, Vedel JP, Grosgogeat Y: Rhythme réciproque antidromic dans un syndrome de Wolff-Parkinson-White de Type A (abstr.). Ann Cardiol Angeiol 24: 59, 1975.
Benditt DG, Pritchett ELC, Gallagher JJ: Spectrum of regular tachycardias with wide QRS complexes in patients with accessory atrioventricular pathways. Am J Cardiol 42: 828–838, 1978.
Akhtar M: Electrophysiologic bases for wide QRS complex tachycardia. PACE 6: 81–98, 1983.
Smith WM, Broughton A, Reiter MJ, Benson DW, Grant AO, Gallagher JJ: Bystander accessory pathway during AV node re-entrant tachycardia. PACE 6: 537–547, 1983.
Zipes DP, DeJoseph RL, Rothbaum DA: Unusual properties of accessory pathways. Circulation 49: 1200–1214, 1974.
Wellens HJJ: Modes of initiation of circus movement tachycardia in 139 patients with the Wolff-Parkinson-White syndrome studied by programmed electrical stimulation. In: Kulbertus HE (ed.), Re-entrant Arrhythmias. Mechanisms and Treatment. MTP Press, Lancaster, 153–169, 1977.
Grolleau R, Dufoix R, Puech P, Latour H: Les tachycardias par rhythme réciproque dans 1e syndrome de Wolff-Parkinson-White. Arch Mal Coeur 63: 74–96, 1970.
Kuck KH, Brugada P, Wellens HJJ: Observations on the antidromic circus movement tachycardia in the Wolff-Parkinson-White syndrome. J Am Coll Cardiol 2: 1003–1010. 1983.
Sung RJ, Castellanos A, Mallon SM, Bloom MG, Gelband H, Myerburg RJ: Mechanisms of spontaneous alternation between reciprocating tachycardia and atrial flutter-fibrillation in the Wolff-Parkinson-White syndrome. Circulation 56: 409–417, 1977.
Wellens HJJ, Durrer D: The role of an accessory atrioventricular pathway in reciprocal tachycardia. Observation in patients with and without Wolff-Parkinson-White syndrome. Circulation 52: 58–64, 1975.
Belhassen B, Misrahi D, Shapira I, Laniado S: Longitudinal dissociation in an anomalous accessory atrioventricular pathway. Am Heart J 106: 1441–1443, 1983.
Bardy GH, Packer DL, Lawrence DG, Gallagher JJ: Preexcited reciprocating tachycardia in patients with Wolff-Parkinson-White syndrome: incidence and mechanisms. Circular 70: 377–391, 1984.
Klein GJ, Sharma AD, Milstein S: Initial evaluation of the patient with the Wolff-Parkinson-White syndrome. In: Benditt DG, Benson DW (eds). Cardiac Pre-excitation Syndromes: Origin, Evaluation and Treatment. Martinus Nijhoff, Boston, 305–320, 1986.
Sherf L, Ncufeld HN: General consideration. In: Sherf L, Neufeld HN (eds). The Pre-excitation Syndrome: Facts and Theories. Yorke Medical Books, New York, 1–35. 1978.
Klein GJ, Bashore TM, Scilers TD, Pritchett ELG, Smith WM, Gallagher JJ: Ventricular fibrillation in the Wolff-Parkinson-White syndrome. N Engl J Med 301: 1080–1085, 1979.
Dreifus LS, Haiat R, Watanabe Y, Arriaya J, Reitman NC: Ventricular fibrillation: a possible mechanism of sudden death in patients with Wolff-Parkinson-White syndrome. Circulation 43: 520–527, 1971.
Colavita PG, Packer DL, Pressley JC, Ellenbogen KA, O’Callaghan WG, Giblert MR, German LD: Frequency, diag-nosis and clinical characteristics of patients with multiple accessory atrioventricular pathways. Am J Cardiol 59: 601–606, 1987.
Wellens HJJ, Brugada P: Value of programmed stimulation of the heart in patients with Wolff-Parkinson-White syndrome. In: Josephson ME, Wellens HJJ (eds), Tachycardias. Lea & Febiger, Philadelphia, 189–222, 1984.
Author information
Authors and Affiliations
Editor information
Rights and permissions
Copyright information
© 2000 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Atié, J. et al. (2000). Clinical and electrophysiologic characteristics of patients with antidromic circus movement tachycardia in the Wolff-Parkinson-White syndrome. In: Smeets, J.L.R.M., Doevendans, P.A., Josephson, M.E., Kirchhof, C., Vos, M.A. (eds) Professor Hein J.J. Wellens. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4110-9_44
Download citation
DOI: https://doi.org/10.1007/978-94-011-4110-9_44
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-5799-8
Online ISBN: 978-94-011-4110-9
eBook Packages: Springer Book Archive