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. 1978 Feb;40(2):147–152. doi: 10.1136/hrt.40.2.147

Identical twins with differing forms of ventricular pre-excitation.

D H Bennett, B Gribbin, J S Birkhead
PMCID: PMC482790  PMID: 565206

Abstract

Identical 10-year-old twins, both with electrocardiograms showing a short PR interval and a normal QRS complex but with dramatically different electrophysiological characteristics, are described. One twin experienced episodes of rapid palpitation and on one occasion was resuscitated from ventricular fibrillation. An intracardiac electrophysiological study confirmed the presence of an atrioventricular nodal bypass tract and in addition revealed the presence of an accessory atrioventricular pathway, thus demonstrating that the patient had both the Lown-Ganong-Levine and Wolff-Parkinson-White syndromes. Re-entry tachycardia and atrial fibrillation, with a very rapid ventricular rate, were precipitated. After treatment with amiodarone, the patient became asymptomatic and a repeat study showed that the features of the atrioventricular nodal bypass tract were no longer present and though re-entry tachycardias using the accessory atrioventricular pathway could still be induced, their rates were slower than before treatment. The other twin, in spite of an identical surface electrocardiogram, was asmymptomatic. An electrophysiological study showed the features of an atrioventricular nodal bypass tract but there was no evidence of additional atrioventricular accessory connections and a tachycardia could not be induced.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brechenmacher C., Courtadon M., Jourde M., Yermia J. C., Cheynel J., Voegtlin R. Syndrome de Wolff-Parkinson-White par association de fibres atrio-hissiennes et de fibres de Mahaïm. Confrontation entre l'électrophysiologie et l'histologie. Arch Mal Coeur Vaiss. 1976 Dec;69(12):1275–1283. [PubMed] [Google Scholar]
  2. Brodsky M., Wu D., Denes P., Rosen K. M. Familial atrial tachyarrhythmia with short PR interval. Arch Intern Med. 1977 Feb;137(2):165–169. [PubMed] [Google Scholar]
  3. Caracta A. R., Damato A. N., Gallagher J. J., Josephson M. E., Varghese P. J., Lau S. H., Westura E. E. Electrophysiologic studies in the syndrome of short P-R interval, normal QRS complex. Am J Cardiol. 1973 Feb;31(2):245–253. doi: 10.1016/0002-9149(73)91037-0. [DOI] [PubMed] [Google Scholar]
  4. Castellanos A., Jr, Castillo C. A., Agha A. S., Tessler M. His bundle electrograms in patients with short P-R intervals, narrow QRS complexes, and paroxysmal tachycardias. Circulation. 1971 May;43(5):667–678. doi: 10.1161/01.cir.43.5.667. [DOI] [PubMed] [Google Scholar]
  5. Gallagher J. J., Sealy W. C., Kasell J., Wallace A. G. Multiple accessory pathways in patients with the pre-excitation syndrome. Circulation. 1976 Oct;54(4):571–591. doi: 10.1161/01.cir.54.4.571. [DOI] [PubMed] [Google Scholar]
  6. HARNISCHFEGER W. W. Hereditary occurrence of the pre-excitation (Wolff-Parkinson-White) syndrome with re-entry mechanism and concealed conduction. Circulation. 1959 Jan;19(1):28–40. doi: 10.1161/01.cir.19.1.28. [DOI] [PubMed] [Google Scholar]
  7. LOWN B., GANONG W. F., LEVINE S. A. The syndrome of short P-R interval, normal QRS complex and paroxysmal rapid heart action. Circulation. 1952 May;5(5):693–706. doi: 10.1161/01.cir.5.5.693. [DOI] [PubMed] [Google Scholar]
  8. Massumi R. A. Familial Wolff-Parkinson-White syndrome with cardiomyopathy. Am J Med. 1967 Dec;43(6):951–955. doi: 10.1016/0002-9343(67)90254-9. [DOI] [PubMed] [Google Scholar]
  9. Massumi R. A., Vera Z. Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome. Am J Cardiol. 1971 Nov;28(5):541–554. doi: 10.1016/0002-9149(71)90096-8. [DOI] [PubMed] [Google Scholar]
  10. McINTIRE M. S., FREED A. E. The Wolff-Parkinson-White syndrome; report of a case occurring in a mother and infant. AMA Am J Dis Child. 1955 Jun;89(6):743–747. [PubMed] [Google Scholar]
  11. Spurrell R. A., Krikler D., Sowton E. Two or more intra AV nodal pathways in association with either a James or Kent extranodal bypass in 3 patients with paroxysmal supraventricular tachycardia. Br Heart J. 1973 Feb;35(2):113–122. doi: 10.1136/hrt.35.2.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Wellens H. J. Contribution of cardiac pacing to our understanding of the Wolff-Parkinson-White syndrome. Br Heart J. 1975 Mar;37(3):231–241. doi: 10.1136/hrt.37.3.231. [DOI] [PMC free article] [PubMed] [Google Scholar]

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