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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Discussion In this case, the clinical and electrophysiologic characteristics were consistent with a diagnosis of Lown-Ganong-Levine syndrome, with a short PR interval, normal QRS complex, without a delta wave, and paroxysmal tachycardia. D ICD – Case Report A year-old man presented to our institution with a history of recurrent narrow-complex and wide-complex tachycardia.

If this were the case, when this EAVNC was injured during catheter manipulation and by catheter ablation with intermittent AH prolongationadenosine should have resulted in a further lengthening of the AH or caused AV block.

Lown-Ganong-Levine Syndrome | Doctor | Patient

Two stable AH intervals coexisted in the same atrial pacing cycle length. Williams and Wilkins; Baltimore: At one-year follow-up, there was no clinical recurrence of tachycardia in this patient.

Pre-operative management of such patients is challenging for an anaesthesiologist. The features of Lown-Ganong-Levine syndrome are compared with those of EAVNC and included analysis of the AV nodal recovery curves obtained before and after adenosine challenge and cryo-ablation. This page was last edited on 9 Decemberat We use cookies to understand site usage and to improve lrvine content and offerings on our sites.

The clinical and electrophysiologic features of a case of recurrent narrow-complex and wide-complex tachycardia on electrocardiogram ECGin a year-old man, are presented.

Lown-Ganong-Levine Syndrome

Instead, the retrograde slow AV nodal pathway was eventually ablated successfully at the right lower mid septal area above the coronary sinus ostium. 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.


Similar electrophysiologic findings with supraventricular tachycardia SVT and without a delta wave are seen in enhanced atrioventricular nodal conduction EAVNCwith the underlying pathophysiology due to a fast pathway to the AV node, and with the diagnosis requiring specific electrophysiologic criteria. The only morbidity associated with the syndrome is the occurrence of paroxysmal episodes of tachycardia which may be of several types, including sinus tachycardia, supraventricular tachycardia, atrial fibrillation, atrial flutter, or even ventricular tachycardia.

Received Aug 22; Accepted Dec In the otherwise healthy person there is probably no other feature but, where the heart and circulation are already compromised, perhaps from coronary heart disease, this can produce angina pectoris, shortness of breath and heart failure. Since the James fiber is close to the normal AV nodal tissue, cryoablation, with its reversibility in case of an adverse event of AV block, should be used if necessary.

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

Dougherty A, Naccarelli G. Lown Ganong Levine LGL syndrome is a rare short PR interval pre-excitation cardiac conduction abnormality, characterised by episodes of palpitation, giddiness, paroxysmal tachycardia, and lveine ECG findings. If you continue using our website, we’ll assume that you are happy to receive all cookies on this website. Support Center Support Center. Cardiovascular disease heart I00—I52— Tachycardia reduces the duration of both systole and diastole but it is diastole that is reduced more.

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

Infobox medical condition new. Please review our privacy policy. Postoperatively she remained asymptomatic and was discharged on eighth postoperative day.

The retrograde ventriculoatrial VA conduction had decremental properties. With isoproterenol challenge, which is a sympathomimetic for beta-receptors, 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.


Lown Ganong Levine syndrome patients are prone to attacks of paroxysmal tachycardia specially supraventricular; however, occasional episodes of atrial fibrillation are usually of short duration and rarely sustained. It does not end in or activate the myocardium directly leading to the absence of delta waves and facilitates reciprocal return of impulse to atria, which may initiate a reciprocating tachyarrhythmia.

In order to avoid these unpleasant outcomes we planned to administer total intravenous anaesthesia using propofol through manually controlled infusion technique supplemented with epidural for postoperative analgesia.

Bernard Lown was born inWilliam Ganong was born and Samuel Albert Levine was born in and died in Join the discussion on the forums.

She was pre-medicated with 1 mg midazolam i. 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. There was no demonstrable retrograde slow AV nodal pathway conduction and no inducible AV nodal re-entry with or without isoproterenol challenge.

Since the tachycardia in this case was caused by fast and slow AV nodal re-entrant tachycardia and the antegrade effective refractory period of the James fiber was relatively long msin retrospect, there syndro,e have been no need to ablate the James fiber lonh this case. Assess your symptoms online with our free symptom checker. We’d love to send you our articles and latest news by email, giving you the best opportunity to stay up to date with expert written health and lifestyle content.

Unfortunately, this case showed no evidence of retrograde AV conduction through the James fiber. This site uses Akismet to reduce spam.