Pacing site and bradycardia dependent retrograde conduction block over an atrioventricular accessory pathway

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
Rong BaiJorge A Salerno-Uriarte

Abstract

Intermittent retrograde conduction over an accessory pathway (AP) is an uncommon phenomenon. We report a case of Wolff-Parkinson-White syndrome in which retrograde conduction of the bypass tract was present only during right ventricular (RV) outflow tract and left ventricular pacing or during RV inflow tract pacing with a fast pacing rate (pacing site and bradycardia dependent conduction block). The interaction between different branches/fibres of the bypass tract might explain the mechanism of this phenomenon. The AP was successfully ablated at the lateral aspect of mitral valve annulus. It is suggested that careful evaluation by decremental ventricular stimulation should be applied from multiple sites both during baseline study and after apparent AP ablation in order to detect such uncommon cases of intermittent conduction.

References

Jul 1, 1992·Pacing and Clinical Electrophysiology : PACE·F SuzukiK Hiejima
Feb 1, 1994·Journal of Cardiovascular Electrophysiology·M S Spach, M E Josephson
Dec 12, 1997·Journal of Cardiovascular Electrophysiology·M SugutaY Iesaka
Jan 22, 1998·Journal of Cardiovascular Electrophysiology·M SchlüterK H Kuck

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Citations

Dec 6, 2008·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Roberto RordorfMaurizio Landolina
Oct 1, 2011·Pacing and Clinical Electrophysiology : PACE·Rogelio Robledo-NolascoHumberto Castro-Villacorta

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