A 29-year-old male with supraventricular tachyarrhythmias is suspected to have Wolff-Parkinson-White (WPW) syndrome. The following is/are true:
- Electrophysiologic studies (EPS) will require catheters in or at the right atrium, His bundle, right ventricle and coronary sinus
- Pacing for EPS uses stimuli twice the diastolic threshold
- The anomalous conducting bundle (Kent) is found in the right free wall if the coronary sinus catheter records the earliest atrial activity during reciprocating tachycardia
- If the atrial catheter records the earliest activity during tachycardia, the bundle of Kent is located in the left free wall
- If neither left or right bundle-branch block prolong the VA interval, the anomalous bundle is in the septum
Medicine
b. Pacing for EPS uses stimuli twice the diastolic threshold
e. If neither left or right bundle-branch block prolong the VA interval, the anomalous bundle is in the septum
For supraventricular arrhythmias, EPS requires catheters placed in the right atrium and ventricle, coronary sinus and His bundle. A programmable stimulator is used for stimuli that are twice the diastolic threshold and 2 msec in duration. When the coronary sinus catheter records the earliest activity during reciprocating tachycardia, the bundle of Kent is in the left free wall while it is in the right free wall if the earliest activity is in the atrial catheter. When neither left or right bundle-branch block prolong the VA interval, the bundle is in the septum.
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