

First diagnosed paroxysm of atrial fibrillation during catheter ablation for Wolf–Parkinson–White syndrome
https://doi.org/10.30629/0023-2149-2025-103-2-146-151
Abstract
Central Military Clinical Hospital named after P.V. Mandryk of the Ministry of Defense of Russia, Moscow, Russia The Wolff–Parkinson–White (WPW) syndrome is a relatively rare arrhythmia compared to atrial fibrillation and atrial flutter; however, after excluding atrial fibrillation and flutter from the statistics, pre-excitation syndromes of the ventricular myocardium account for 25% of supraventricular tachycardias. Due to the characteristic clinical picture on the ECG, which is often sufficient for diagnosing the condition, patients with WPW syndrome are quickly referred to specialized hospitals for further treatment. Currently, catheter ablation is the primary method of treating WPW syndrome. This article presents a clinical case of intraoperative induction of atrial fibrillation with frequent antegrade conduction to the ventricular myocardium via an accessory atrioventricular connection.
About the Authors
V. I. SteklovRussian Federation
Vladimir I. Steklov — Doctor of Medical Sciences, Associate Professor,
Head of the Center for Interventional Cardiology, Arrhythmology and
Electrocardiostimulation of X-ray Surgical Methods of Diagnosis and
Treatment
Moscow
S. O. Lependin
Russian Federation
Sergey O.Lependin — cardiovascular surgeon at the Department of
X-ray Surgical Methods for the Diagnosis and Treatment of Complex
Cardiac Arrhythmias
Moscow
N. V. Morozova
Russian Federation
Natalia V. Morozova — Head of the Functional Diagnostics Office
at the Center for Interventional Cardiology, Arrhythmology and
Electrocardiostimulation of X-ray Surgical Methods of Diagnosis and
Treatment
Moscow
References
1. Ardashev A.V., Rybachenko M.S., Zhelyakov E.G. et al. Wolf–Parkinson–White syndrome: classifi cation, clinical manifestations, diagnosis and treatment. Cardiology. 2009;10. (In Russian).
2. Sapra A., Albers J., Bhandari P. et al. Wolff–Parkinson–White syndrome: a master of disguise. Cureus. 2020;12(6) e8672. DOI: 10.7759/cureus.8672
3. Chernova A.A., Matyushin G.V., Nikulina S.Y. Wolf– Parkinson–White syndrome (literature review). RMJ. 2017;4:269-272. (In Russian).
4. Mamchur S.E., Ardashev A.V. Sudden cardiac death and Wolf–Parkinson–White syndrome. Clinical practice. 2014:4. (In Russian).
5. Clinical recommendations of Supraventricular tachycardia. Ministry of Health of the Russian Federation. Year of approval: 2020. (In Russian).
6. Miklashevich I.M., Shkolnikova M.A., Syrkin A.L. et al. The natural course of supraventricular tachyarrhythmias, manifested in childhood. Bulletin of Arrhythmology. 2002;29. (In Russian).
7. Steklov V.I., Morozova N.V., Silantieva L.B. and others. Cardiac arrhythmias in patients with coronavirus infection. Military Medical Journal. 2022;10. (In Russian).
8. Wu J.-T., Zhao D.-Q., Li F.-F. et al. Advanced interatrial block predicts recurrence of atrial fibrillation after accessory pathway ablation in patients with Wolff–Parkinson–White syndrome. Clin. Cardiol. 2019;42:806–811. DOI: 10.1002/clc.23222
9. Jiameng Ren, Yanmin Yang, Jun Zhu et al. The use of intravenous amiodarone in patients with atrial fibrillation and Wolff –Parkinson– White syndrome. PACE. 2021;44(1). DOI: 10.1111/PACE.14113
10. Della Bella P., Brugada P., Talajic M. et al. Atrial fibrillation in patients with an accessory pathway: Importance of the conduction properties of the accessory pathway. J. Am. Coll. Cardiol. 1991;17:1352–1356
11. Mu Chen, Qunshan Wang, Jian Sun et. al. Early repolarization in the inferior leads after accessory pathway ablation is highly correlated with atrial fibrillation in Wolff–Parkinson–White syndrome. Journal of Cardiology. 2020;75:323–329. DOI: 10.1016/j.jjcc.2019.07.017
12. Wu J.-T., Zhao D.-Q., Li F.-F. et al. Effect of pulmonary vein isolation on atrial fibrillation recurrence after accessory pathway ablation in patients with Wolff–Parkinson–White syndrome. Clin. Cardiol. 2020;43:1511–1516. DOI: 10.1002/clc.23470
13. Debasis Acharya, Sameer Rane, Shomu Bohora et. al. Incidence, clinical, electrophysiological characteristics and outcomes of patients with Wolff–Parkinson–White syndrome and atrial fibrillation. Indian Pacing and Electrophysiology Journal. 2020;20:3e7. DOI: 10.1016/j.ipej.2019.12.015
14. Borregaard R., Lukac P., Gerdes C. et al. Radiofrequency ablation of accessory pathways in patients with the Wolff–Parkinson–White syndrome: the long-termmortality and risk of atrial fibrillation. Europace. 2014. DOI: 10.1093/europace/euu176
15. Nunes A., Lebreiroa A., Campelo M. et al. Iatrogenic ventricular fi brillation in Wolff–Parkinson–White syndrome. Revista Portuguesa de Cardiologia. 2022;41:973.e1-973.e4. DOI: 10.1016/j.repc.2019.06.008
16. Hong Yi L., Lee Ye e L., KuanYee L. Atrial fibrillation with pre-arousal syndrome in an 81-year-old patient: a clinical case. Bulletin of Arrhythmology. 2023;30(4): e16–e19. (In Russian). DOI: 10.35336/VA-121
17. Vatasescu, R.G., Paja, C.S.; Sus, I. et al. Wolf–Parkinson–White Syndrome: Diagnosis, Risk Assessment, and Therapy — An Update. Diagnostics. 2024, 14, 296. DOI: 10.3390/diagnostics14030296
18. Andy Kieu, Vikram Nangia. Atrial fibrillation in Wolff–Parkinson– White Syndrome. JACC: Case reports. 2019:1(3). DOI: 10.1016/j.jaccas.2019.07.032
19. Syuhei Ikeda, Yoshimori An, Masami Yanagisawa. Iatrogenic ventricular fibrillation caused by in appropriately synchronized cardioversion in a patient with pre-excited atrial fibrillation: A case report. Journal of Cardiology Cases. 2021;23:31–34. DOI: 10.1016/j.jccase.2020.08.014
Review
For citations:
Steklov V.I., Lependin S.O., Morozova N.V. First diagnosed paroxysm of atrial fibrillation during catheter ablation for Wolf–Parkinson–White syndrome. Clinical Medicine (Russian Journal). 2025;103(2):146-151. (In Russ.) https://doi.org/10.30629/0023-2149-2025-103-2-146-151