Int J Arrhythm.  2021 Jun;22(2):5. 10.1186/s42444-021-00033-z.

Hypertrophic cardiomyopathy with  paroxysmal atrial fibrillation misdiagnosed as WPW syndrome

• Seol S
• Kim K
• Park J
• Song Y
• Kim D
• Kim D

• KMID: 2517276
• DOI: http://doi.org/10.1186/s42444-021-00033-z

Abstract

Hypertrophic cardiomyopathy (HCM) is associated with an increased incidence of Wolff–Parkinson–White (WPW) syndrome and atrial fibrillation. However, a delta-like wide QRS can be observed in the hypertrophied myocardium. When considering the rarity of the paraseptal bypass tract (BT), the normal QRS axis suggests a higher possibility of HCM origin. Otherwise, there is no known electrocardiographic clue indicating a wide QRS differentiation between HCM and WPW syndrome. Moreover, the atriofascicular, nodofascicular/ventricular or fasciculoventricular BT should be differentiated. In this case, atrioventricular conduction system incidental injury revealed a wide QRS origin from the HCM, but this method should be avoided except in some selected cases.

Keyword

Atrial fibrillation; Hypertrophic cardiomyopathy; WPW syndrome