Concertina effect – Cardiology MCQ

Concertina effect is seen in:
a) WPW syndrome
b) Deployed stents
c) Both of the above
d) None of the above
Correct answer: c) Both of the above
Concertina effect in WPW Syndrome
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.
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.1 It has been mentioned that those manifesting concertina effect is likely to have higher accessory pathway refractory period.2
Concertina effect with stents
Concertina effect is longitudinal deformation of the proximal segments of a deployed due to force from the guide catheter or other equipment.3
References

  1. Giraud G, Latou H, Puech P, RouJon J. Rhythm disorders of the WPW syndrome, endocavitary electrocardiographic analysis. Montpellier Med. 49: 101, 1956.
  2. Singla V, Singh B, Singh Y, Ravindranath KS. Concertina effect: a subtle but specific marker. BMJ Case Rep. 2013 Apr 30;2013. pii: bcr2013009328. doi: 10.1136/bcr-2013-009328.
  3. Foin N, Di Mario C, Francis DP, Davies JE. Stent flexibility versus concertina effect: mechanism of an unpleasant trade-off in stent design and its implications for stent selection in the cath-lab. Int J Cardiol. 2013 Apr 15;164(3):259-61.

Add a Comment

Your email address will not be published. Required fields are marked *