Mesut AYDIN, MEHMET ZİHNİ BİLİK, Abdulkadir YILDIZ, Hilal ÖZBEK, Yahya İSLAMOĞLU

Wolf Parkinson White Sendromuna Tipik Atriyoventriküler Nodal Reentran Taşikardinin Eşlik Ettiği Olgu

Çarpıntı ataklarında artış olması nedeniyle ile 31 yaşındaki kadın kliniğimize başvurdu. Çekilen EKG'de delta dalgası, kısa PR, geniş QRS olduğu görülerek Wolf Parkinson White (WPW) sendromu saptandı. Yapılan elektrofizyolojik çalışmada (EPS) aksesuar yolun sol serbest duvar lateral bölgede olduğu belirlendi. Radyofrekans yöntemi ile aksesuar yol ablasyonu başarılı bir şekilde yapıldı. Aksesuar yol ablasyonu yapıldıktan sonra EPS tekrarlandı. Aksesuar yolun olmadığı görüldü. Test esnasında atriyoventriküler nodalreentran taşikardi (AVNRT) indüklendi. Yavaş yol ablasyonu radyofrekans enerji yöntemi ile başarılı bir şekilde yapıldı. Sonuç olarak WPW sendromlu hastalarda aksesuar yol ablasyonu yapıldığında ablasyon sonrası herhangi bir taşikardinin özellikle AVNRT'nin indüklenmediği gösterilmelidir, çünkü WPW sendromu olan on kişiden birinde WPW sendromuna AVNRT eşlik etmektedir. Özellikle başarılı aksesuar yol ablasyonlarından sonra devam eden çarpıntı şikayetleri AVNRT'den kaynaklanıyor olabilir

A Case of Wolf-Parkinson-White Syndrome Coexisting With Typical Atrioventricular Nodal Reentrant Tachycardia

A 31-year-old female patient was admitted to hospital with complaintsof increased palpitation attacks. Delta wave,short PR interval and wide QRS wave were detected on ECG and the patient was diagnosed as Wolf Parkinson White syndrome (WPW). Electrophysiological study was performed. Accessory pathway in lateral region of the left free wall was determined. Radiofrequency ablation of accessory pathway was performed successfully. Electrophysiological study was repeated after accessory pathway ablation. There was no accessory pathway observed during the test, but atrioventricular nodal reentrant tachycardia (AVNRT) was induced. Slow pathway ablation with radiofrequency energy method was successfully performed. As a conclusion we may assume that it is important to show there will be no tachycardia induced especially the AVNRT after performing an ablation of accessory pathway in patients with WPW syndrome, Because one in ten patient with WPW syndrome is accompanied with AVNRT. Especially after successful ablation of accessory pathways, the ongoing complaints of palpitation may be caused by AVNRT

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