[Skip to Content]
[Skip to Content Landing]
Article
March 1980

Persistent Fetal Dispersion of the Atrioventricular Node: Association With the Wolff-Parkinson-White Syndrome

Author Affiliations
From the University of Strasbourg (Dr Brechenmacher) and the University of Tours (Dr Fauchier), France, and the University of Alabama, Birmingham (Dr James).
Arch Intern Med. 1980;140(3):377-382. doi:10.1001/archinte.1980.00330150091022
Abstract

• Symptomatic supraventricular tachycardias developed in a 58-year-old man not long before he also was found to have metastatic cancer. During electrophysiological studies, type A Wolff-Parkinson-White syndrome was defined and at least four different forms of supraventricular tachycardias were documented. When he died of his cancer, autopsy studies included special examination of his heart and its conduction system. There was a slender connection between the left atrium and left ventricle posterior to the margo obtusus, composed of ordinary working myocardial cells. There was also persistent fetal dispersion of the atrioventricular (AV) node within the central fibrous body, forming a suitable anatomical substrate for reentrant tachycardias originating entirely there. The anatomical and electrophysiological findings are discussed relative to the question of surgery in such patients, since cutting the lateral AV connections might eliminate the delta wave but not the supraventricular tachycardias.

(Arch Intern Med 140: 377-382, 1980)

References
1.
Wolff L, Parkinson J, White PD:  Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia.  Am Heart J 5:685-704, 1930.Crossref
2.
Castillo CA, Castellanos A Jr:  His bundle recordings in patients with reciprocating tachycardias and Wolff-Parkinson-White syndrome.  Circulation 42:271-285, 1970.Crossref
3.
Wellens HJJ, Schuilenburg RM, Durrer D:  Electrical stimulation of the heart in patients with Wolff-Parkinson-White syndrome, type A.  Circulation 43:99-114, 1971.Crossref
4.
Coumel Ph, Waynberger M, Fabiato A, et al:  W.P.W. syndrome: Problems in evaluation of multiple accessory pathways and surgical therapy.  Circulation 45:1216-1230, 1972.Crossref
5.
Frank R: Apport des investigations endocavitaires et des cartographies épicardiques dans l'étude des syndromes de prêexcitation ventriculaires, thesis. Paris, Editions Medicales et Universitaires, 1974.
6.
Gallagher JJ, Gilbert M, Svenson RH, et al:  Wolff-Parkinson-White syndrome: The problem, evaluation and surgical correction.  Circulation 51:767-785, 1975.Crossref
7.
Gallagher JJ, Svenson RH, Sealy WC, et al:  The Wolff-Parkinson-White syndrome and the preexcitation dysrhythmias: Medical and surgical management.  Med Clin North Am 60:101-123, 1976.
8.
Rosenbaum FF, Hecht HH, Wilson FN, et al:  The potential variations of the thorax and esophagus in anomalous atrioventricular excitation (W.P.W. syndrome).  Am Heart J 29:281-326, 1945.Crossref
9.
James TN, Marshall TK:  De subitaneis mortibus: XVIII. Persistent fetal dispersion of the atrioventricular node and His bundle within the central fibrous body.  Circulation 53:1026-1034, 1976.Crossref
10.
James TN:  Morphology of the human atrioventricular node, with remarks pertinent to its electrophysiology.  Am Heart J 62:756-771, 1961.Crossref
11.
Lev M, Gibson S, Miller R:  Ebstein's disease with WPW syndrome: Report of a case with a histopathologic study of possible conduction pathways.  Am Heart J 49:724-741, 1955.Crossref
12.
Lev M, Kennamer R, Prinzmetal M, et al:  A histopathological study of the atrioventricular communications in two hearts with the WPW syndrome.  Circulation 24:41-50, 1961.Crossref
13.
Lev M, Sodi Pallares D, Friedland C:  A histopathological study of the atrioventricular communications in a case of WPW with incomplete left bundle-branch block.  Am Heart J 66:399-408, 1963.Crossref
14.
James TN, Puech P:  De subitaneis mortibus: IX. Type A Wolff-Parkinson-White syndrome.  Circulation 50:1264-1280, 1974.Crossref
15.
Brechenmacher C, Laham Y, Iris L, et al:  Etude histologique des voies anormales de conduction dans un syndrome de Wolff-Parkinson-White et dans un syndrome de Lown-Ganong-Levine.  Arch Mal Coeur 67:507-519, 1974.
16.
Brechenmacher C, Coumel Ph, James TN:  De subitaneis mortibus: XVI. Intractable tachycardia in infancy.  Circulation 53:377-381, 1976.Crossref
×