Mehmet Zihni BİLİK, Yahya İSLAMOĞLU, Murat YÜKSEL, Abdulkadir YILDIZ, Mesut AYDIN

Sol Serbest Duvarda Çift Aksesuar Yolun Olduğu Wolf Parkinson White Sendromunun Nadir Bir Antitesi

Wolff-Parkinson-White sendromu ile bir erkek hasta başvurdu. Elektrofizyolojik çalışma yapıldı. Sol ventrikülde posterolateral ve lateral olmak üzere iki aksesuar yol tespit ettik. Radyofrekans enerji ile çift aksesuar yol ablasyonu başarılı bir şekilde yaptık. Elektrokardiyografi aksesuar yolun yerini tespit etmede en önemli invaziv olmayan tek araçtır. Bizim vakamızda EKG’de V1-6, I, II, aVL + olarak gördük. Sol taraflı aksesuar yol olduğunu gösteriyordu. Posterolateral yol aksesuar yol ablasyonu yapıldıktan sonra aVL’nin negatif olduğunu gördük bu da sol lateral aksesuar yol olduğunu gösteriyordu. Çoklu aksesuar yollar belli kombinasyonlarda bulunur fakat çoklu aksesuar yollar arasında sağ posteroseptal ve sağ serbest duvar aksesuar yolların birlikte bulunması daha sıktır. Bizim olgumuzun özelliği çift yolun sol serbest duvarda olmasıydı.

Anahtar Kelimeler:

Wolf Parkinson White sendromu, aksesuar yol, elektrokardiografi

Left Free Wall Dual Accesorry Pathway in Wolf Parkinson White Syndrome; A Rare Entity

A seventeen year-old male presented with Wolff-Parkinson-White syndrome. Electrophysiology study was performed. Two accesorry pathways were detected at left ventricule lateral and posterolateral locations. We perfomed a successful radiofrequency ablation to these dual accesorry pathways. Electrocardiography is the single most important noninvasive tool for identifying the presence of an accesorry pathway. In our case, V1-V6, I, II, aVL were positive on baseline ECG. This was a sign of leftsided accesorry pathway. After elimination of posterolateral accesorry pathway, aVL was negative indicating a left free wall accesorry pathway. Multiple pathways are found in any combination but there is a higher incidence of right free wall and posteroseptal pathway coexistence in patients with multiple pathways than in those with a single pathway. Otherwise, in our case both of the accesorry pathways were in left free wall.

Keywords:

Wolf Parkinson White syndrome, accessory pathway, electrocardiography,

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