Preview

Journal of Arrhythmology

Advanced search

First presentation of atrial fibrillation with pre-excitation syndrome in octogenarian

https://doi.org/10.35336/VA-1211

Abstract

Palpitation is a symptom of cardiac arrhythmia commonly presented at hospital admission. It has a wide range of clinical importance, from subtle insignificant cardiac ectopic beats to life-threatening cardiac arrhythmias with a risk of sudden cardiac death. Approach to palpitation emphasizes on the identification of its primary cause which relies strongly on the underlying risk factors and age groups. Cardiac arrhythmias due to innate cardiac conductive disorders such as accessory pathway in Wolff-Parkinson-White syndrome tend to present at a younger age while arrhythmias related to ischemic heart disease occur mostly in the elderly population. We report a case of first diagnosed atrial fibrillation in an 81-year-old patient with previously unknown pre-excitation syndrome.

About the Authors

L. Hong Yee
Department of Internal Medicine, Hospital Sultan Idris Shah Serdang
Malaysia

Jalan Puchong, 43000 Kajang, Selangor Darul Ehsan



L. Lee Yee
Department of Internal Medicine, Queen Elizabeth Hospital II, Kota Kinabalu
Malaysia

Lim Lee Yee.

Sabah, D-26-06, Menara Suezcap 1 KL Gateway, No. 2 Jalan Kerinchi Gerbang Kerinchi Lestari 59200 Kuala Lumpur



L. Kuan Yee
Department of Medicine, Hospital Canselor Tuanku Muhriz
Malaysia

Jalan Yaacob Latif Kuala Lumpur, Bandar Tun Razak, 56000 Cheras, Wilayah Persekutuan Kuala Lumpur



References

1. Trzeciak S, Erickson T, Bunney EB, Sloan EP. Variation in patient management based on ECG interpretation by emergency medicine and internal medicine residents. The American Journal of Emergency Medicine. 2002;20(3): 188-195. https://doi.org/10.1053/ajem.2002.32628.

2. Kim SS, Knight BP. Long term risk of Wolff-Parkinson-White pattern and syndrome. Trends in Cardiovascular Medicine. 2017;27(4): 260-268. https://doi.org/10.1016/j.tcm.2016.12.001.

3. Goudevenos JA, Katsouras CS, Graekas G et al. Ventricular pre-excitation in the general population: a study on the mode of presentation and clinical course. Heart (British Cardiac Society). 2000;83(1): 29-34. https://doi.org/10.1136/heart.83.1.29.

4. Krahn AD, Manfreda J, Tate RB et al. The natural history of electrocardiographic preexcitation in men. The Manitoba Follow-up Study. Annals of Internal Medicine. 1992;116(6): 456-460. https://doi.org/10.7326/0003-4819-116-6-456.

5. Brembilla-Perrot B, Holban I, Houriez P et al. Influence of age on the potential risk of sudden death in asymptomatic Wolff-Parkinson-White syndrome. Pacing and clinical electrophysiology: PACE. 2001;24(10): 1514-1518. https://doi.org/10.1046/j.1460-9592.2001.01514.x.

6. Rosner MH, Brady Jr WJ, Kefer MP et al. Electrocardiography in the patient with the Wolff-Parkinson-White syndrome: diagnostic and initial therapeutic issues. The American Journal of Emergency Medicine. 1999;17(7): 705-714. https://doi.org/10.1016/s0735-6757(99)90167-5.

7. Sethi KK, Dhall A, Chadha DS et al. WPW and preexcitation syndromes. The Journal of the Association of Physicians of India. 2007;55 Suppl: 10-15.

8. Campbell RW, Smith RA, Gallagher JJ et al. Atrial fibrillation in the preexcitation syndrome. The American Journal of Cardiology. 1977;40(4): 514-520. https://doi.org/10.1016/0002-9149(77)90065-0.

9. Szumowski Ł, Orczykowski M, Derejko P, et al. Predictors of the atrial fibrillation occurrence in patients with Wolff-Parkinson-White syndrome. Kardiologia Polska. 2009;67(9): 973-978.

10. Garratt C, Ward D, Antoniou A, et al. Misuse of verapamil in pre-excited atrial fibrillation. Lancet (London, England). 1989;1(8634): 367-369. https://doi.org/10.1016/s0140-6736(89)91734-0.

11. McGovern B, Garan H, Ruskin JN. Precipitation of cardiac arrest by verapamil in patients with Wolff-Parkinson-White syndrome. Annals of Internal Medicine. 1986;104(6): 791-794. https://doi.org/10.7326/0003-4819-104-6-791.

12. Katritsis DG, Arbelo E, Arribas F et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). European Heart Journal. 2020;41(5): 655-720. https://doi.org/10.1093/eurheartj/ehz467.

13. Koźluk E, Timler D, Zyśko D et al. Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome. Cardiology Journal. 2015;22(3): 247-252. https://doi.org/10.5603/CJ.a2014.0086.


Review

For citations:


Hong Yee L., Lee Yee L., Kuan Yee L. First presentation of atrial fibrillation with pre-excitation syndrome in octogenarian. Journal of Arrhythmology. 2023;30(4):e16-e19. https://doi.org/10.35336/VA-1211

Views: 282


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1561-8641 (Print)
ISSN 2658-7327 (Online)