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Patient
21-year-old man hospitalized for syncope; first tracing recorded during a precarious hemodynamic state of the patient;
Trace
Characteristic pattern of atrial fibrillation due to accessory pathway; Irregular tachycardia with very short RR cycles (cycles measured at 200 ms) with cycle-to-cycle variations in QRS pattern including narrow QRS and QRS with various degree of pre-excitation;
Trace
This patient underwent electrical shock under brief sedation; sinus rhythm with left lateral pre-excitation pattern (short PR, delta wave);
Exergue
The incidence of atrial fibrillation is considerably increased in patients with Wolff-Parkinson-White syndrome. The ablation of the accessory pathway significantly reduces the occurrence of this type of arrhythmia which exposes the patient to the risk of sudden death.
Atrial fibrillation episodes are documented in approximately one third of patients with Wolff-Parkinson-White syndrome. The incidence of atrial flutter and tachycardia on the other hand does not appear to be increase.