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A Case of Intermittent Preexcitation and Palpitations: More than Meets the Eye.
J Innov Card Rhythm Manag. 2019 Nov; 10(11):3892-3895.JI

Abstract

We discuss the case of a 22-year-old female who presented to the clinic experiencing recurrent palpitations. She was also found to have intermittent preexcitation on her electrocardiogram (ECG). Her palpitations were attributed to stress. Previously, she had gone to the emergency department a few times and was diagnosed with sinus tachycardia. Her ECG revealed a right-sided accessory pathway. Given her atypical finding of orthodromic reciprocating tachycardia, a 30-day event monitor was implanted, which revealed that one episode was correlated with sinus tachycardia, with a heart rate of 120 bpm. She mentioned experiencing other episodes that were severe, but she did not activate the monitor manually at the time of these incidents. After a long discussion with the patient about available management options for her symptoms, it was decided to proceed with long-term monitoring with an implantable loop recorder to gather better symptom-rhythm correlation data. At six months after surgery, the patient experienced multiple manually triggered transmissions from her device, which were all consistent with sinus tachycardia. She had no episode suggestive of any supraventricular tachycardia and is thus being treated for inappropriate sinus tachycardia. This case highlights the importance of gathering adequate symptom-rhythm correlation data before pursuing more invasive treatment options for an arrhythmic etiology in low-risk patients.

Authors+Show Affiliations

Michigan State University, McLaren Greater Lansing Hospital, Lansing, MI, USA.St. Marys of Michigan, Saginaw, MI, USA.Martinsburg VA Medical Center, Marinsburg, WV, USA.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32477709

Citation

Kanjwal, Khalil, et al. "A Case of Intermittent Preexcitation and Palpitations: More Than Meets the Eye." The Journal of Innovations in Cardiac Rhythm Management, vol. 10, no. 11, 2019, pp. 3892-3895.
Kanjwal K, Kanjwal S, Haji AQ. A Case of Intermittent Preexcitation and Palpitations: More than Meets the Eye. J Innov Card Rhythm Manag. 2019;10(11):3892-3895.
Kanjwal, K., Kanjwal, S., & Haji, A. Q. (2019). A Case of Intermittent Preexcitation and Palpitations: More than Meets the Eye. The Journal of Innovations in Cardiac Rhythm Management, 10(11), 3892-3895. https://doi.org/10.19102/icrm.2019.101102
Kanjwal K, Kanjwal S, Haji AQ. A Case of Intermittent Preexcitation and Palpitations: More Than Meets the Eye. J Innov Card Rhythm Manag. 2019;10(11):3892-3895. PubMed PMID: 32477709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Case of Intermittent Preexcitation and Palpitations: More than Meets the Eye. AU - Kanjwal,Khalil, AU - Kanjwal,Shaffi, AU - Haji,Abdul Q, Y1 - 2019/11/15/ PY - 2019/01/30/received PY - 2019/04/11/accepted PY - 2020/6/2/entrez PY - 2020/6/2/pubmed PY - 2020/6/2/medline KW - Loop recorder KW - Wolff–Parkinson–White syndrome KW - supraventricular tachycardia SP - 3892 EP - 3895 JF - The Journal of innovations in cardiac rhythm management JO - J Innov Card Rhythm Manag VL - 10 IS - 11 N2 - We discuss the case of a 22-year-old female who presented to the clinic experiencing recurrent palpitations. She was also found to have intermittent preexcitation on her electrocardiogram (ECG). Her palpitations were attributed to stress. Previously, she had gone to the emergency department a few times and was diagnosed with sinus tachycardia. Her ECG revealed a right-sided accessory pathway. Given her atypical finding of orthodromic reciprocating tachycardia, a 30-day event monitor was implanted, which revealed that one episode was correlated with sinus tachycardia, with a heart rate of 120 bpm. She mentioned experiencing other episodes that were severe, but she did not activate the monitor manually at the time of these incidents. After a long discussion with the patient about available management options for her symptoms, it was decided to proceed with long-term monitoring with an implantable loop recorder to gather better symptom-rhythm correlation data. At six months after surgery, the patient experienced multiple manually triggered transmissions from her device, which were all consistent with sinus tachycardia. She had no episode suggestive of any supraventricular tachycardia and is thus being treated for inappropriate sinus tachycardia. This case highlights the importance of gathering adequate symptom-rhythm correlation data before pursuing more invasive treatment options for an arrhythmic etiology in low-risk patients. SN - 2156-3977 UR - https://www.unboundmedicine.com/medline/citation/32477709/A_Case_of_Intermittent_Preexcitation_and_Palpitations:_More_than_Meets_the_Eye_ DB - PRIME DP - Unbound Medicine ER -
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