Ventricular fibrillation in the Wolff-Parkinson-White syndrome

Klein, George J.; Bashore, Thomas M.; Sellers, T. D.; Pritchett, Edward L. C.; Smith, William M.; Gallagher, John J.

doi:10.1056/nejm197911153012003

Cited by 830Cardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmiasAtrial Fibrillation Management and Outcomes

Ventricular fibrillation in the Wolff-Parkinson-White syndrome

Klein, George J., Bashore, Thomas M., Sellers, T. D., Pritchett, Edward L. C., Smith, William M., Gallagher, John J.·1979·New England Journal of Medicine

DOI 10.1056/nejm197911153012003

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Abstract

To examine the risk of ventricular fibrillation in patients with the Wolff-Parkinson-White syndrome, we compared patients who had this syndrome and a history of ventricular fibrillation related to preexcitation with patients who had the syndrome without this history. Ventricular fibrillation occurred during atrial fibrillation, with rapid conduction over the accessory pathway, and these patients had a higher prevalence of both reciprocating tachycardia and atrial fibrillation (14 of 25 vs. 18 of 73, P = 0.004) and multiple accessory pathways (five of 25 vs. four of 73, P = 0.012). The shortest preexcitation R-R interval during atrial fibrillation was less in the group with ventricular fibrillation (mean shortest R-R, 180 vs. 240 milliseconds, P less than 0.0001) as was the average R-R interval (mean average R-R, 269 vs 340 milliseconds, P less than 0.0001). Patients with Wolff-Parkinson-White syndrome who are most susceptible to ventricular fibrillation have a history of atrial fibrillation and reciprocating tachycardia, demonstrate rapid conduction over an accessory pathway during atrial fibrillation and have multiple accessory pathways.

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Atrial fibrillation with a fast ventricular response is potentially life-threatening in patients with WPW syndrome because it can degenerate into ventricular fibrillation.
“Atrial fibrillation with fast ventricular response is a potentially lifethreatening arrhythmia in patients with WPW syndrome due to degeneration in VF. 306,307”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [306]

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Authors: Klein, G. J., Bashore, T. M., Sellers, T. D., Pritchett, E. L. C., Smith, W. M., & Gallagher, J. J.
Affiliations: Duke University (US)
ORCID: Klein, George J.
Bashore, Thomas M.
Gallagher, John J.
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 1979-11-15
Volume: 301
Issue: 20
Pages: 1080-1085
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejm197911153012003
OpenAlex: W2752265893
Cited by: 830
References: 23
Citations by year: 2026: 6 · 2025: 9 · 2024: 9 · 2023: 11 · 2022: 13 · 2021: 18 · 2020: 23 · 2019: 16 · 2018: 11 · 2017: 20 · 2016: 12 · 2015: 27 · 2014: 26 · 2013: 21 · 2012: 42
FWCI: 7.62
Type: journal article
Language: en
Open access: closed
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Keywords: ventricular fibrillation, Wolff-Parkinson-White syndrome, preexcitation, atrial fibrillation, accessory pathway, reciprocating tachycardia, multiple accessory pathways, RR interval, risk factors
MeSH terms: Adolescent, Adult, Aged, Arrhythmias, Cardiac, Atrial Fibrillation, Child, Electrocardiography, Female, Heart Conduction System, Humans, Male, Middle Aged, Risk, Tachycardia, Ventricular Fibrillation, Wolff-Parkinson-White Syndrome

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Ventricular fibrillation in the Wolff-Parkinson-White syndrome

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