Unmasking latent preexcitation of a right‐sided accessory pathway with intravenous adenosine after unexplained sudden cardiac arrest

Intravenous adenosine is a simple test that can uncover latent preexcitation via an accessory pathway and is useful in the diagnostic workup of sudden cardiac arrest survivors without an identifiable cause. Latent preexcitation is usually associated with left free wall pathways but may also occur in...

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Bibliographic Details
Published in:Journal of arrhythmia 2020-10, Vol.36 (5), p.939-941
Main Authors: Foo, Fang Shawn, Stiles, Martin K., Heaven, David
Format: Article
Language:English
Subjects:
Ablation
Adenosine
Atrial fibrillation
Cardiac arrest
Cardiac arrhythmia
Cardiac Arrhythmia Spot Light
Catheters
Conflicts of interest
Defibrillators
Diagnostic tests
Electrocardiogram
Electrocardiography
Heart
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Summary:Intravenous adenosine is a simple test that can uncover latent preexcitation via an accessory pathway and is useful in the diagnostic workup of sudden cardiac arrest survivors without an identifiable cause. Latent preexcitation is usually associated with left free wall pathways but may also occur in right‐sided accessory pathways with slow antegrade conduction. Although intermittent ECG evidence of preexcitation is generally considered a marker of low risk for sudden death, if this is due to an accessory pathway with long atrioventricular conduction time and short effective refractory period (rather than true intermittent conduction via the pathway), the risk for sudden death may be equal to those accessory pathways with manifest preexcitation.
ISSN:1880-4276
1883-2148
DOI:10.1002/joa3.12408