This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by DURRER, D. Articles by ROOS, J. P. Search for Related Content PubMed PubMed Citation Articles by DURRER, D. Articles by ROOS, J. P.

(Circulation. 1967;35:15.)
© 1967 American Heart Association, Inc.

---

Epicardial Excitation of the Ventricles in a Patient with Wolff-Parkinson-White Syndrome (Type B)

D. DURRER M.D.¹ J. P. ROOS M.D.¹

¹ From the University Department of Cardiology and Clinical Physiology, Wilhelmina-Gasthuis, Amsterdam, and the Department of Cardiology, University of Leiden.

Epicardial excitation was explored by means of an exploring electrode during operation on a patient with a large atrial septal defect of the secundum type, whose ECG indicated a Wolff-Parkinson-White syndrome of type B. Very early excitation occurred, 10 msec after the end of the P wave, at the right lateral border, near the atrioventricular sulcus, an area which is located a relatively large distance from the atrioventricular node. Because the epicardial region closest to this node did not show early excitation, it was concluded that in this heart the node was not involved, but that a muscular bypass between the right atrial muscle and the closely adjacent right ventricular surface was responsible. The location corresponds with that described in several extensive anatomic studies of hearts with a WPW syndrome. The right ventricle was activated predominantly or completely by an excitation wave originating in this area; the excitation pattern of the left ventricle did not differ significantly from the normal.

Key Words: Pre-excitation • Atrial septal defect

This article has been cited by other articles:

				S. Hanon, M. Shapiro, and P. Schweitzer Early history of the pre-excitation syndrome Europace, January 1, 2005; 7(1): 28 - 33. [Abstract] [Full Text] [PDF]

				H. J.J. Wellens Cardiac arrhythmias: The quest for a cure: A historical perspective J. Am. Coll. Cardiol., September 15, 2004; 44(6): 1155 - 1163. [Abstract] [Full Text] [PDF]

				A. G. KLEBER and Y. RUDY Basic Mechanisms of Cardiac Impulse Propagation and Associated Arrhythmias Physiol Rev, April 1, 2004; 84(2): 431 - 488. [Abstract] [Full Text] [PDF]

				P. A. Doevendans and H. J. Wellens Wolff-Parkinson-White Syndrome: A Genetic Disease? Circulation, December 18, 2001; 104(25): 3014 - 3016. [Full Text] [PDF]

				M. J. Janse, T. Opthof, and A. G. Kleber Animal models of cardiac arrhythmias Cardiovasc Res, July 1, 1998; 39(1): 165 - 177. [Full Text] [PDF]

				H. J. J. Wellens, P. Brugada, and O. C. Penn The Management of Preexcitation Syndromes JAMA, May 1, 1987; 257(17): 2325 - 2333. [Abstract] [PDF]

				K. Rosen Introduction to the Cardiac Electrophysiology Symposium Arch Intern Med, March 1, 1975; 135(3): 387 - 387. [Abstract] [PDF]

				J. P. Boineau, E. N. Moore, W. C. Sealy, and J. H. Kasell Epicardial Mapping in Wolff-Parkinson-White Syndrome Arch Intern Med, March 1, 1975; 135(3): 422 - 431. [Abstract] [PDF]

				H. J. Wellens Pathophysiology of Ventricular Tachycardia in Man Arch Intern Med, March 1, 1975; 135(3): 473 - 479. [Abstract] [PDF]

				C. R. C. Wyndham, F. L. Amat-y-Leon, P. Denes, R. C. Dhingra, S. O. Burman, J. M. Pouget, and K. M. Rosen Posterior Left Ventricular Preexcitation: Report of a Case Arch Intern Med, August 1, 1974; 134(2): 243 - 249. [Abstract] [PDF]

				T. N. JAMES The Wolff-Parkinson-White Syndrome Ann Intern Med, August 1, 1969; 71(2): 399 - 405. [Abstract] [PDF]