The Role of Exercise Testing in Wolff-Parkinson-White Syndrome: About Two Cases

Dib Hassan

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco and Unit of Pedagogy and Research of Cardiology, Mohamed V University, Morocco.

Karimou Bondabou Abdoul Wahab *

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco and Unit of Pedagogy and Research of Cardiology, Mohamed V University, Morocco.

Bouzouba Otman

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco and Unit of Pedagogy and Research of Cardiology, Mohamed V University, Morocco.

Nana Yeboah Frederick

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco and Unit of Pedagogy and Research of Cardiology, Mohamed V University, Morocco.

El Bahri Loubna

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco and Unit of Pedagogy and Research of Cardiology, Mohamed V University, Morocco.

Oketokoun Arike Rachidath

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco.

Fellat Nadia

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco and Unit of Pedagogy and Research of Cardiology, Mohamed V University, Morocco.

Fellat Rokya

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco and Unit of Pedagogy and Research of Cardiology, Mohamed V University, Morocco.

Cherti Mohamed

Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Morocco and Unit of Pedagogy and Research of Cardiology, Mohamed V University, Morocco.

*Author to whom correspondence should be addressed.


Abstract

Exercise testing (ET) is a noninvasive test used both in the diagnosis of myocardial ischemia and in the risk stratification of sudden death in Wolff-Parkinson-white syndrome (WPW). However, in the latter, there are often false-positive results through ST-segment depression even though the coronaries are healthy. This has largely limited the interpretation of the clinical and electrical features suggestive of myocardial ischemia during ET in patients with WPW syndrome. The purpose of this study is to present two cases of myocardial ischemia revealed by ET in patients with WPW syndrome.

Keywords: Wolff-Parkinson-White syndrome, exercise testing, myocardial ischemia, sudden death


How to Cite

Hassan, Dib, Karimou Bondabou Abdoul Wahab, Bouzouba Otman, Nana Yeboah Frederick, El Bahri Loubna, Oketokoun Arike Rachidath, Fellat Nadia, Fellat Rokya, and Cherti Mohamed. 2023. “The Role of Exercise Testing in Wolff-Parkinson-White Syndrome: About Two Cases”. Asian Journal of Cardiology Research 6 (1):18-22. https://journalajcr.com/index.php/AJCR/article/view/128.


References

Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41(3):407–477.

Moltedo JM, Iyer RV, Forman H, Fahey J, Rosenthal G, Snyder CS. Is exercise stress testing a cost-saving strategy for risk assessment of pediatric wolff-Parkinson-white syndrome patients? Ochsner J. 2006;6(2):64–67.

Sapra A, Albers J, Bhandari P, Davis D, Ranjit E. Wolff-Parkinson-White Syndrome: A Master of Disguise. Cureus. 2020; 12(6):e8672-e8673.

Lu C-W, Wu M-H, Chen H-C, Kao F-Y, Huang S-K. Epidemiological profile of Wolff-Parkinson-White syndrome in a general population younger than 50 years of age in an era of radiofrequency catheter ablation. Int J Cardiol. 2014;174(3):530–534.

Cain N, Irving C, Webber S, Beerman L, Arora G. Natural history of Wolff-Parkinson-White syndrome diagnosed in childhood. Am J Cardiol. 2013;112(7):961–965.

Benson DW, Cohen MI. Wolff-Parkinson-White syndrome: lessons learnt and lessons remaining. Cardiol Young. 2017;27(S1):S62–S67.

Mohan S, Balaji S. Management of asymptomatic ventricular preexcitation. Indian Pacing Electrophysiol J. 2019; 19(6):232–239.

Jezior M, Kent S, Atwood J. Exercise Testing in Wolff-Parkinson-White Syndrome *: Case Report With ECG and Literature Review. Chest. 2005;127: 1454–7.

Kanwal A, Bustin KM, Delasobera BE, Shah AB. Ischaemia during exercise stress testing in an athlete with Wolff-Parkinson-White pattern. BMJ Case Rep CP. 2020;13(4):e235055.

Vijay Y, Sanjeev T, Ratna Mani G, Chandra Mani P, Bhawani M, Manju S, et al. A Wolff-Parkinson-White (WPW) Electrocardiographic Pattern in Asymptomatic Patient – State-of-the-Art-Review. J Cardiol Cardiovasc Med. 2022;7(2):045–052.

Gatzoulis K, Apostolopoulos T, Costeas X, Sotiropoulos H, Papafanis F, Stefanadis C, Toutouzas P. Paraseptal accessory connections in the proximity of the atrioventricular node and the His bundle. Additional observations in relation to the ablation technique in a high risk area. Europace. 2004 ;6(1): 1-9.

DOI: 10.1016/j.eupc.2003.10.001

Pappone C, Santinelli V, Rosanio S, Vicedomini G, Nardi S, Pappone A, Tortoriello V, Manguso F, Mazzone P, Gulletta S, Oreto G, Alfieri O. Usefulness of invasive electrophysiologic testing to stratify the risk of arrhythmic events in asymptomatic patients with Wolff-Parkinson-White pattern: results from a large prospective long-term follow-up study. J Am Coll Cardiol. 2003;41(2): 239-44.