Lown-Ganong-Levine Syndrome. by Chris Nickson, Last updated January 2, OVERVIEW. bypass close to the AV node connecting the left atrium and the. Background: Lown-Ganong-Levine syndrome, includes a short PR interval, normal QRS complex, and paroxysmal tachycardia. INTRODUCTION. Lown Ganong Levine (LGL) syndrome is a rare short PR interval pre-excitation cardiac conduction abnormality, characterised by episodes of.

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If the James fiber had retrograde AV conduction, it would have been possible to also evaluate the anatomical difference in the atrial insertion site between the James fiber and the fast AV nodal pathway. Maintenance fluid was Lactated Ringers solution administered as per calculation for the patient. After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne.

Received Aug 22; Accepted Dec Background Lown-Ganong-Levine syndrome, with the electrocardiographic ECG findings of a short PR interval, a normal QRS complex, and paroxysmal tachycardia, was first described in [ 1 ], and was further characterized by Lown, Ganong, and Levine in [ 2 ]. D ICD – Male, 17 Final Diagnosis: The pathophysiology of this syndrome includes an accessory pathway connecting the atria and the atrioventricular AV node James fiberor between the atria and the His bundle Brechenmacher fiber.

Adequate pre-operative preparation, appropriate selection of anaesthetic agents and technique, vigilant intra-operative monitoring, avoiding factors that can trigger tachyarrythmias, malignant hyperthermia, and cardiac arrest along with good postoperative pain relief measures would go a long way in successfully managing these group of patients even in peripheral hospitals not equipped with sophisticated equipments.

Schamroth L, Krikler DM. He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. This site uses Akismet to reduce spam. On his recent hospital admission, the electrophysiologic studies showed an extremely short baseline atrial to His AH conduction interval of 22 ms, and a normal His to ventricle HV interval, without a delta wave Figure 2.

However, EP studies have been unable to identify a single accessory pathway or structural abnormality in all individuals with LGL syndrome. With isoproterenol challenge, which is a sympathomimetic for ganon, ventricular pacing induced a sustained fast-slow AV nodal reentrant tachycardia with an AH of 71 ms and HA of ms and the earliest retrograde atrial depolarization was recorded at the area of the ostium of the coronary sinus.


The WPW and related syndromes; pp. LGL syndrome is one such rare type of short PR interval abnormality described in Cardiac fibrosis Heart failure Diastolic heart failure Cardiac asthma Rheumatic fever.

Analysis of anterograde and retrograde fast pathway properties in patients with dual atrioventricular nodal pathways. This single case report is of Lown-Ganong-Levine syndrome associated with accessory pathway James fiber conduction, but this single case does not attempt to apply this finding to the cause in all cases of this syndrome.

Lown-Ganong-Levine Syndrome

Once thought to involve an accessory conduction pathway, it is grouped with Wolff—Parkinson—White syndrome as an atrioventricular re-entrant tachycardia AVRT. National Center for Biotechnology InformationU. She was pre-medicated with 1 mg midazolam i. This case had the features described by James, as an accessory pathway connection from the atrium to the distal AV node [ 3 ].

A year-old man presented to our institution with a history of recurrent narrow-complex and wide-complex tachycardia.

Anaesthetic management of a patient with Lown Ganong Levine syndrome—a case report

If you continue using our website, we’ll assume that syndrpme are happy to receive all cookies on this website. However, subsequent studies have shown that a short PR interval in the absence of symptomatic tachycardia is simply a benign EKG variant.

The clinical fast and slow AV nodal re-entrant tachycardia syndroome an antegrade normal AV nodal pathway and a retrograde slow AV nodal pathway. Published online Mar Irrelevant, but the doctor had to go through my jugular to get a needle in and then hit me with the defibrullators can’ The occurence of frequent paroxysms of tachycardia in patients with a short PR interval and normal QRS duration had been described by Clerc et al in but it was the Americans who achieved the immortality of an eponym.

The ventricles do not have adequate syndome to fill in diastole and this may reduce cardiac output. Your email address will not be published.


Assess your symptoms online with our free symptom checker. Total intra-venous anaesthesia is a technique of general anaesthesia using a combination of agents given solely by intravenous route in the absence of all inhalational agents including nitrous oxide. You can opt out at any time or find out more by reading our cookie policy. From Wikipedia, the free encyclopedia.

However, attempted cryoablation ofthe James fiber proved its presence.

Lown-Ganong-Levine Syndrome

Pre-operative management of such patients is challenging for an anaesthesiologist. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy.

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Retrieved from ” https: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Dougherty A, Naccarelli G. Anaesthesia was maintained by a three-step propofol infusion technique as proposed by Prys-Roberts and colleagues. Without deformation of the ventricular complex Arch Mal Coeur. The history is of bouts of tachycardia that may present syndrkme rapid palpitations.

Anaesthetic management of a patient with Lown Ganong Levine syndrome—a case report

From A1A2 to the two recovery curves were superimposable, and this was presumed to be the James fiber effective refractory period. Although tachycardia, along with increased stroke volume, enables cardiac output to meet demands in exercise, a very fast tachycardia is inefficient and may cause compromise.

Therefore, most consider the disorder to be a clinical syndrome with multiple different underlying causes, all involving some form of intranodal or paranodal fibers that bypass all or part of the atrioventricular AV node with subsequent conduction down the normal His-Purkinje system. With the increasing use of the cardiac electrophysiologic studies and catheter ablation in the evaluation of patients with cardiac pre-excitation syndromes, it is gamong that more cases of Lown-Ganong-Levine syndrome will be studied.