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Europace 2005 7(3):221-224; doi:10.1016/j.eupc.2004.12.003
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

CASE REPORT

Atrial fibrillation triggered by postinfarction ventricular premature beats in a patient with Wolff–Parkinson–White syndrome

Rafael Peinado*, Jose Luis Merino, Mariana Gnoatto and Miguel Angel Arias

Unidad de Arritmias y Electrofisiología, Hospital Universitario "La Paz", Universidad Autónoma Madrid, Spain

The mechanism by which atrial fibrillation is initiated in patients with accessory pathways is not fully understood. Retrograde conduction of ventricular premature beats to the atrium, causing the arrhythmia, is a very rare cause. We report a patient with Wolff–Parkinson–White syndrome (WPW), without previous tachycardias, who presented multiple episodes of paroxysmal atrial fibrillation after having a myocardial infarction. During the electrophysiological (EP) study the patient presented two spontaneous episodes of atrial fibrillation initiated by ventricular premature beats conducted to the atria through the accessory pathway. After successful catheter ablation of the accessory pathway the patient did not present arrhythmia recurrences.

Key Words: Wolff–Parkinson–White syndrome, atrial fibrillation, ventricular premature beats, catheter ablation

*Corresponding author. Unidad de Arritmias, U.M.Q. de Cardiología, Hospital Universitario "La Paz", Paseo de la Castellana 261, 28046 Madrid, Spain. Tel./fax: +34 91 727 7564. E-mail address: rpeinado{at}secardiologia.es (R. Peinado).


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O. A. Centurion, A. Shimizu, S. Isomoto, and A. Konoe
Mechanisms for the genesis of paroxysmal atrial fibrillation in the Wolff--Parkinson--White syndrome: intrinsic atrial muscle vulnerability vs. electrophysiological properties of the accessory pathway
Europace, March 1, 2008; 10(3): 294 - 302.
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