Letter by Jiang and Qiao Regarding Article, “Chest Pain and T-Wave Inversions in a 56-Year-Old Man”
To the Editor:
We read with great interest the wonderful case presented by Verma and Knight1 about cardiac memory after radiofrequency ablation on a patient with Wolf-Parkinson-White syndrome with chest heaviness. However, the patient’s chest tightness with daily episodes remained unexplained, and the chest heaviness was relieved with a normal PR interval after radiofrequency ablation of his accessory bypass tract. From our perspective, the key point of the chest tightness is the elevation of pulmonary venous pressure, caused by a short PR interval and intermittent mitral regurgitation,2 both of which affect the process of ventricular filling. To prove my supposition, could the author provide responses to the following: (1) the patient’s chest tightness should be consistently associated with the intermittent mitral regurgitation or more preexcitation; (2) chest tightness could respond to diuretic therapy or lying down. If the responses to these scenarios are not known, the best way would be to compare the pulmonary capillary wedge pressure preablation and postablation. Not every patient with Wolf-Parkinson-White syndrome has symptoms of chest heaviness, because it may depend on the level of pulmonary venous pressure or other complication.
Xiao-Wei Jiang, MD
Shu-Bin Qiao, MD, PhD
Circulation is available at http://circ.ahajournals.org.
- © 2017 American Heart Association, Inc.