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Precipitation of Ventricular Fibrillation by Intravenous Diltiazem and Metoprolol in a Young Patient with Occult Wolff‐Parkinson‐White Syndrome
Author(s) -
KIM ROBERT J.,
GERLING BARBARA R.,
KONO ALAN T.,
GREENBERG MARK L.
Publication year - 2008
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2008.01086.x
Subject(s) - medicine , metoprolol , cardiology , diltiazem , atrial fibrillation , accessory pathway , sinus rhythm , ventricular fibrillation , occult , normal sinus rhythm , electrocardiography , anesthesia , catheter ablation , alternative medicine , pathology , calcium
We report the case of a young man who presented with a rapid, narrow‐complex atrial fibrillation. A few hours after being administered intravenous metoprolol and diltiazem for rate control, he developed intermittent ventricular preexcitation on the electrocardiogram (ECG) and experienced ventricular fibrillation, from which he was successfully defibrillated. A subsequent electrocardiogram in sinus rhythm demonstrated previously unknown Wolff‐Parkinson‐White pattern. A left lateral accessory pathway was successfully ablated. Wolff‐Parkinson‐White syndrome should be included in the differential diagnosis when a young patient presents with atrial fibrillation, even if the ventricular complexes on the ECG are not preexcited.