{"id":12881,"date":"2015-01-05T03:13:11","date_gmt":"2015-01-05T03:13:11","guid":{"rendered":"http:\/\/cardiophile.org\/?p=12881"},"modified":"2015-01-05T03:13:11","modified_gmt":"2015-01-05T03:13:11","slug":"concertina-effect-in-wpw-syndrome","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/concertina-effect-in-wpw-syndrome\/","title":{"rendered":"Concertina effect in WPW syndrome"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/yP-5REar1CQ\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Concertina effect in WPW syndrome<\/span><\/h2>\n<p><strong>Abstract:&nbsp;<\/strong><em>Varying QRS width in WPW syndrome due to varying degrees of pre-excitation is known as concertina effect in WPW syndrome. The more the pre-excitation, the shorter the PR interval and wider the QRS duration.<\/em><\/p>\n<p>Progressive decrease in PR interval with reciprocal increase in QRS width due to changing degree of pre-excitation has been termed concertina effect in WPW syndrome. It may be noted that the PJ interval (from the beginning of P wave to the end of QRS) remains constant.<sup>1<\/sup> It has been mentioned that those manifesting concertina effect is likely to have higher accessory pathway refractory period.<sup>2<\/sup> This would translate to lower ventricular rates in case of occurrence of atrial&nbsp;fibrillation and hence lesser chance of sudden cardiac death. It may be noted the WPW syndrome with atrial fibrillation is a potentially life threatening situation because of the very fast ventricular rates which can lead on to ventricular fibrillation. Atrial fibrillation with fast ventricular rate&nbsp;is encountered in accessory pathways with short refractory periods, typically less than two hundred and fifty milliseconds.<\/p>\n<p>Concertina effect has been described during an episode of vasospastic angina in a person with WPW syndrome.<sup>3<\/sup> In this case, a gradual prolongation of AH interval was documented in the His bundle electrogram.<\/p>\n<p><strong><span style=\"color: #0000ff;\">References<\/span><\/strong><\/p>\n<ol>\n<li>Giraud G, Latou H, Puech P, RouJon J. Rhythm disorders of the WPW syndrome, endocavitary electrocardiographic analysis. Montpellier Med. 49: 101, 1956.<\/li>\n<li>Singla V, Singh B, Singh Y, Ravindranath KS. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3645649\/\">Concertina effect: a subtle but specific marker<\/a>.&nbsp;BMJ Case Rep. 2013 Apr 30;2013. pii: bcr2013009328. doi: 10.1136\/bcr-2013-009328.<\/li>\n<li>Nakagawa S, Maeda K, Imamura T, Kondoh H, Koiwaya Y, Tanaka K. Increasing pre-excitation (&#8220;concertina effect&#8221;) during vasospastic angina.&nbsp;J Electrocardiol. 1986 Jul;19(3):299-302.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Concertina effect in WPW syndrome is varying QRS width in WPW syndrome due to varying degrees of pre-excitation. More the pre-excitation, shorter the PR and wider the QRS.<\/p>\n","protected":false},"author":1,"featured_media":28755,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6],"tags":[857,4132,4133,4271],"class_list":["post-12881","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","tag-concertina-effect","tag-varying-degrees-of-pre-excitation","tag-varying-qrs-width-in-wpw-syndrome","tag-wpw-syndrome"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Concertina effect in WPW syndrome<\/title>\n<meta name=\"description\" content=\"Concertina effect is varying QRS width in WPW syndrome due to varying degrees of pre-excitation. More the pre-excitation, shorter the PR and wider the QRS.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/concertina-effect-in-wpw-syndrome\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Concertina effect in WPW syndrome\" \/>\n<meta property=\"og:description\" content=\"Concertina effect is varying QRS width in WPW syndrome due to varying degrees of pre-excitation. 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