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ABSTRACT Background Methods Results Conclusions Wolff‐Parkinson‐White (WPW) syndrome and fasciculoventricular pathway (FVP) present electrocardiographic manifestations characterized by delta waves, differentiating these two is challenging. Specifically, WPW type B with QRS width ≤120 ms, resembles typical FVP features. Because of the presence of repolarization abnormalities in WPW syndrome, our hypothesis centered on the potential utility of the QRS‐T angle for distinguishing WPW syndrome from FVP. To determine the discriminative value of the QRS‐T angle for delineating WPW syndrome from FVP.We included cases of WPW syndrome treated with catheter ablation and FVP diagnosed via adenosine triphosphate administration between 2007 and 2023. We excluded cases with WPW type A, QRS width >120 ms, intermittent WPW, congenital heart disease or myocardial damage, ablation history, tachycardia, palpitations within 3 months, and WPW syndrome featuring an accessory pathway on the left lateral wall. Eventually, we identified 40 and 54 patients from the WPW and FVP groups, respectively. The QRS‐T angle was compared between the WPW and FVP cohorts.The QRS‐T angle in the WPW group was significantly larger than in the FVP group (45.7 ± 46.3° vs. 17.8 ± 13.9°, p < 0.001). Receiver operating characteristic curve analysis with a sensitivity and specificity of 65.0% and 72.6%, respectively, demonstrated that the optimal cut‐off value for the QRS‐T angle was 22° for distinguishing WPW from FVP. Remarkably, all cases with a QRS‐T angle >65° were within the WPW group.The QRS‐T angle can offer promising utility in differentiating WPW syndrome from FVP. [ABSTRACT FROM AUTHOR]

Background: T‐wave memory (TWM) is a rare cause of T‐wave inversion (TWI). Alterations in ventricular activation due to abnormal depolarization may cause repolarization abnormalities on the ECG, even if myocardial conduction returns to normal. These repolarization changes are defined as TWM. In our study, we aimed to determine the frequency of TWM development and the predictors affecting it in the pediatric population who underwent accessory pathway (AP) ablation due to Wolff‐Parkinson‐White (WPW) syndrome. Methods: The data of patients with manifest AP who underwent electrophysiological studies and ablation between 2015 and 2021 were retrospectively analyzed. The study included 180 patients who were under 21 years of age and had at least one year of follow‐up after ablation. Patients with structural heart disease, intermittent WPWs, recurrent ablation, other arrhythmia substrates, and those with less than one‐year follow‐up were excluded from the study. The ECG data of the patients before the procedure, in the first 24 h after the procedure, three months, and in the first year were recorded. The standard ablation technique was used in all patients. Results: Postprocedure TWM was observed in 116 (64.4%) patients. Ninety‐three patients (51.7%) had a right‐sided AP, and 87 patients (48.3%) had a left‐sided AP. The presence of posteroseptal AP was found to be significantly higher in the group that developed TWM. Of these patients, 107 (93.1%) patients showed improvement at the end of the first year. Preprocedural absolute QRS‐T angle, postprocedural PR interval, and right posteroseptal pathway location were identified as predictors of TWM. Conclusion: The development of TWM is particularly associated with the right‐sided pathway location, especially the right posteroseptal pathway location. The predictors of TWM are the preprocedural QRS‐T angle, the postprocedural PR interval, and the presence of the right posteroseptal AP. [ABSTRACT FROM AUTHOR]

The article present case study of a 52-year-old woman who had been previously diagnosed with type-A Wolff-Parkinson-White (WPW) syndrome. Topics include the diagnostic assessment of a narrow QRS tachycardia; differential diagnosis between orthodromic reciprocating tachycardia (ORT) and atrioventricular nodal reentrant tachycardia (AVNRT); and the complexities in distinguishing a posteroseptal atrioventricular pathway from a rare nodoventricular pathway.

A cascade Wolff rearrangement and double N‐acylation reaction has been developed for the synthesis of fused pyrimidinediones in one‐pot under air. These reactions were performed with α‐diazoketones and 2‐aminopyridines or 3‐aminopyrazoles under catalyst‐ and additive‐free conditions. The protocol avoided traditional purification procedures, such as organic solvent extraction and column chromatography. The synthesis of biologically active molecules and gram‐scale experiment demonstrated the potential applications of this reaction. [ABSTRACT FROM AUTHOR]

During catheter ablation (CA) of tachycardia, conventional point‐by‐point mapping may be hindered due to hemodynamic instability. We performed open‐window mapping (CARTO, Biosense Webster, USA) in a patient who developed hemodynamic instability during orthodromic atrioventricular reciprocating tachycardia (AVRT) and unwarranted induction of AVRT during attempts to map accessory pathway (AP) with ventricular pacing. With over 11,000 points acquired rapidly, the system accurately identified AP at the mitral valve (MV) annulus where the application of single radiofrequency (RF) lesion promptly eliminated AP's conduction. Our case illustrates the utility of open‐window mapping for the ablation of AVRT. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction Methods and Results Conclusion Catheter ablation (CA) is the first‐line treatment with a high success rate for patients with symptomatic Wolff–Parkinson–White syndrome, while three‐dimensional (3D) mapping systems enable the identification of accessory pathways (APs). We aimed to develop a novel mapping method using wave‐speed mapping (WSM) to determine AP locations and CA outcomes.This study included 19 patients diagnosed with atrioventricular (AV) reciprocating tachycardia. We compared local activation time (LAT) mapping and WSM, and analyzed the relationship between the “high‐speed islets” in WSM and successful ablation sites. Sixteen APs were located on the left, three on the septum, and one on the right side. The median number of mapping points and mapping time were 1451 points and 14.6 min, respectively. All 20 APs in the 19 patients were eliminated using “high‐speed islets” in WSM. Eleven APs (55%) were eliminated after the first ablation application. One patient with an anteroseptal AP close to the AV node underwent cryoablation to avoid an AV block. The AP width in the 3D mapping system was significantly narrower in WSM than in LAT mapping (5.8 ± 4.0 mm vs. 10.4 ± 3.2 mm, p < .001). One patient experienced an AP recurrence, successfully eliminated using WSM‐guided CA in a repeat procedure. During 13.1 ± 8.3 months of follow‐up, all patients remained free of any supraventricular tachycardias.WSM is a novel mapping method for visualizing APs as “high‐speed islets” and guides a more precise ablation site than LAT mapping. [ABSTRACT FROM AUTHOR]

The enantioselective addition of potent nucleophiles to ketenes poses challenges due to competing background reactions and poor stereocontrol. Herein, we present a method for enantioselective phosphoric acid catalyzed amination of ketenes generated from α‐aryl‐α‐diazoketones. Upon exposure to visible light, the diazoketones undergo Wolff rearrangement to generate ketenes. The phosphoric acid not only accelerates ketene capture by amines to form a single configuration of aminoenol intermediates but also promotes an enantioselective proton‐transfer reaction of the intermediates to yield the products. Mechanistic studies elucidated the reaction pathway and explained how the catalyst expedited the transformation and controlled the enantioselectivity. [ABSTRACT FROM AUTHOR]

Background: Open‐window mapping (OWM) is a novel automated mapping method for catheter ablation of an accessory pathway (AP), in which the local signal is annotated with window‐of‐interest parameters to analyze both atrial and ventricular signals. This study aimed to determine the utility of OWM in visualizing the location and width of APs in patients with Wolff‐Parkinson‐White syndrome. Methods: This two‐center study enrolled 30 patients (20 males; mean age: 56 years, interquartile range [IQR]: 22–69 years) who underwent high‐density OWM with the extended early‐meets‐late (EEML) algorithm using a 20‐electrode, 5‐spline catheter (PENTARAY, Biosense Webster). The lower threshold of the EEML was set to adjust the EEML gap to match the propagation mapping, and broad APs were defined as an EEML gap > 1 cm. Results: The median mapping points, mapping time, and lower threshold of the EEML were 2482 (IQR: 1755–4000) points, 23 (IQR: 15–30) min, and 23 (IQR: 18–25), respectively. All 30 APs (24 in the mitral annulus and 6 in the tricuspid annulus) were successfully eliminated. Of these APs, 21 (70%) were eliminated by the first radio frequency (RF) application. OWM revealed broad APs in 11 patients (37%), in four of whom (36%) the first RF application achieved a loss of AP conduction (vs. 90% of patients without broad APs; p =.004). Conclusion: OWM facilitates the visualization of the location and width of APs, which may be particularly useful for predicting whether multiple RF applications are required for broad APs. [ABSTRACT FROM AUTHOR]

A photoinduced Wolff rearrangement/chiral isothiourea catalyzed [4+2] cycloaddition reaction of pyrazolone derivatives and α‐diazoketones was developed, affording the corresponding dihydropyrano[2,3‐c]pyrazolone derivatives in moderate to good yields (50–94 %) with satisfactory to excellent diastereoselectivities (>20 : 1 dr, in almost all cases) and enantioselectivities of 31–99 %. This protocol features readily available substrates, mild reaction conditions, and effective construction of vicinal tertiary and quaternary carbon stereocenters. [ABSTRACT FROM AUTHOR]

Background: Wolff‐Parkinson‐White (WPW) syndrome is one of the most common congenital cardiac abnormalities among ventricular pre‐excitation syndromes. Radiofrequency catheter ablation (RFCA) treatment of accessory pathways (APs) in WPW patients is an established curative therapy restoring normal atrioventricular conduction. We have not encountered any studies evaluating both the LA and LV functions of these patients before and after RFCA with three dimensional‐speckle tracking echocardiography (3D‐speckle tracking echocardiography (STE)). Aim: The purpose of the current study was to assess the LA and LV functions in patients with WPW syndrome before and after RFCA using 3D‐STE. Methods: A total of 21 patients with WPW syndrome who had been scheduled for RFCA were prospectively recruited for this study. 3D‐STE examinations of the patients were performed 12–24 h before ablation and 1 month after ablation. Results: The LV‐global longitudinal strain (LV‐GLS) and LV‐global circumferential strain (LV‐GCS) were significantly depressed in the pre‐RFCA WPW group than in the control group (−14.3 ± 2.1 vs. −21.5 ± 2.2, p <.001; −12.6 ± 1.8 vs. −20.4 ± 1.8, p <.001, respectively). The left atrial strain‐reservoir (LAS‐r) and LAS‐active were significantly decreased in the pre‐RFCA WPW group than in the control group (31.9 ± 2.4 vs. 48.8 ± 2.6, p <.001; 11.7 ± 2 vs. 26.5 ± 2.1, p <.001, respectively). The LV‐GLS, LV‐GCS, LAS‐r, and LAS‐active values improved after RFCA compared to before. Conclusion: The results of our study indicated that there are subclinical impairments in LV and LA myocardial dynamics in the apparently healthy WPW patients, and these deteriorations improve after RFCA of AP. [ABSTRACT FROM AUTHOR]

Introduction: We describe one rare case of successful ablation of a right epicardial accessory pathway (AP) via the right ventricular diverticulum in a patient with Wolff‐Parkinson‐White syndrome. Methods: A 42‐year‐old woman was referred to the hospital for a catheter ablation of Wolf‐Parkinson‐White syndrome. The earliest activation was shown to be present in the region of the tricuspid annulus. However, ablation had no effect on the AP. Results: We decided to do a selected angiography, in which a big diverticulum near the right tricuspid annulus was shown to be present. Ablation in this region successfully repressed the AP without any recurrences within a follow‐up period of 12 months. Conclusion: The ventricular diverticulum‐mediated AP is a novel variant of pre‐excitation. It can serve as an anatomical substrate of supraventricular tachycardia, and can be ablated endocardially using an irrigation tip catheter within the diverticulum. [ABSTRACT FROM AUTHOR]

Congenital right atrial aneurysms (RAA) have a wide range of clinical presentations and leads to various complications. Depending on the initial presentation and associated complications, a conservative or surgical approach may be considered. A patient suffering from a giant RAA associated with the Wolff‐Parkinson‐White syndrome, who underwent successful surgical treatment, is presented here. [ABSTRACT FROM AUTHOR]

Thermally promoted tandem Wolff rearrangement – Staudinger [2+2] cycloaddition of α‐cyano‐α‐diazo ketones and imines afforded 3‐cyano‐β‐lactams in good to excellent yields as one diastereomer. The process represents the first example of generating cyanoketenes via the Wolff rearrangement of diazo compounds. The reaction is virtually insensitive to the substitution pattern in both reaction partners. It afforded high product yields even for imines bearing bulky tertiary alkyl substituents at the imine's nitrogen atom, which is indicative of the reaction proceeding predominantly as the concerted [2+2] cycloaddition rather than stepwise N‐acylation – ring closure process. Examples of reductive manipulation of the resulting 3‐cyano‐β‐lactams are provided opening an entry into 3‐aminomethyl 2‐azetidinones and azetidines. [ABSTRACT FROM AUTHOR]

Ebstein anomaly (EA) results from the failure of proper delamination of the tricuspid valve leaflets from the right ventricle (RV) myocardium. The severity of EA occurs on a spectrum that results in varying degrees of tricuspid regurgitation, atrial dilation, RV dilation, and dysfunction. These effects have the potential to create substrates that can give rise to atrial arrhythmia, ventricular arrhythmia, and a greater incidence of Wolff–Parkinson–White (WPW) syndrome Wackel et al. (2018) accounting for 0.5% of all congenital heart diseases (Oh et al. 1985). In the case of atrial fibrillation and WPW, it is very dangerous for the patient because of hemodynamic compromise, syncope, and sudden death. In this case report, we share our experience in using radiofrequency ablation to ablate right lateral accessory pathway, with modified Carpentier technique in operation to treat an adult patient diagnosed with Ebstein anomaly, atrial septal defect, atrial fibrillation, and WPW syndrome. [ABSTRACT FROM AUTHOR]

The potential energy surfaces of the Vinylogous Wolff Rearrangement, an alternative process for the Wolff Rearrangement that takes place β,γ‐unsaturated diazoketones have been fully explored employing M062X model chemistry and in a complementary task by means of the CASSCF method. The NBO analysis has been invoked to reveal the alternations of orbital occupancies and their stabilization energies through some of the critical structures located on the pathways. The calculations establish a two steps process for each pathway involving a second higher energy transition state that seems likely to be the rate determining step in agreement with experimental results. Energy analysis indicates more feasibility of the pathway including diradical intermediate. The most striking feature of the study concerns the finding out a transition state providing a channel in between two pathways through interconversion of the two keys bicyclo[2.1.0]pentanone and diradical intermediates. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Aim Methods Results Conclusion Data are scarce regarding Wolf‐Parkinson White Syndrome (WPW) syndrome and asymptomatic pre‐excitation in Africa. This study tried to understand the current approaches utilized in Africa for the diagnosis and management of both symptomatic and asymptomatic ventricular pre‐excitation.The current prospective study was conducted in 20 centers located in 17 countries spanning all areas of Africa. Participants included had ventricular pre‐excitation patterns. The data collected included symptoms, locations of accessory pathways (AP) and tachyarrhythmia, risk stratification, as well as acute and long‐term management. In addition, we assessed the clinical effectiveness of the centers and the impact of socioeconomic and health metrics on these treatment approaches.Among 541 participants, 93% were diagnosed with WPW syndrome, with orthodromic atrioventricular reciprocating tachycardia (AVRT) being the most prevalent arrhythmia, affecting 55% of the cases. Approximately 30% of patients in Africa, except for the southern region, received intravenous amiodarone as the first‐choice drug for orthodromic AVRT while adenosine was the drug of choice in the Southern region. Electrical cardioversion was the first‐line treatment for pre‐excited atrial fibrillation and antidromic AVRT across all of Africa. Radiofrequency ablation (RF) was the first long‐term therapy option for 88% of patients in all African regions, unlike western and central Africa where it was implemented for less than 30% of patients (p < 0.001). The rates of RF success, long‐term recurrence, and complications were 93%, 4.1%, and 3.8%, respectively.There are significant variations between African regions in terms of diagnostic workup, accessory pathway localizations, and volume of invasive treatment. Countries in Northern and Southern Africa are more advanced than other African countries in terms of modern management strategy. Additional government investments are necessary to enhance diagnostic likelihood and curative treatments as well as to reduce the gap between different regions in Africa. [ABSTRACT FROM AUTHOR]

Background. Wolff-Parkinson-White syndrome is an uncommon cardiac disorder characterized by the presence of one or more accessory pathways that predispose patients to frequent episodes of arrhythmias. The prognosis is usually good, but there is a lifetime risk of malignant arrhythmias and sudden cardiac death. Case Summary. A 25-year-old male presented a witnessed out-of-hospital cardiac arrest with ventricular fibrillation rhythm. Due to rapid initiation of prehospital advanced life support, return of spontaneous circulation was observed. During the transport to the hospital, an irregular wide complex tachycardia suggestive of preexcited atrial fibrillation with haemodynamic instability was also observed and a synchronized shock was applied. Baseline 12-lead electrocardiogram was compatible with sinus rhythm and ventricular preexcitation pattern. After clinical stabilization, an electrophysiological study was performed confirming the presence of a left anterolateral accessory pathway with a short antegrade effective refractory period. Successful radiofrequency catheter ablation was achieved. Discussion. The reported clinical case recalls fundamental features of the Wolff-Parkinson-White syndrome and outlines the increasing evidence and importance of the invasive risk stratification and even catheter ablation in asymptomatic patients who suffer from this uncommon disease that may have a dramatic and fatal initial clinical manifestation. [ABSTRACT FROM AUTHOR]

A novel visible‐light‐driven catalytic activation of C=O bonds by exploiting the photoredox chemistry of 1,3,2‐dioxaphospholes, readily accessible from α‐diketones and trialkyl phosphites, is reported. This mild and environmentally friendly strategy provides an unprecedented and efficient access to the Wolff rearrangement reaction which traditionally entails α‐diazoketones as precursors. The resulting ketenes could be precisely trapped by alcohols/thiols to give α‐aryl (thio)acetates and by imines to afford the valuable β‐lactams in up to 99 % yields. [ABSTRACT FROM AUTHOR]

The role that the desire for self‐worth plays in international relations has become a prominent topic in contemporary political theory. Contemporary accounts are based on the notion of national self‐worth as a function of status; therefore, the desire for national self‐worth is seen as a source of anxiety and conflict over status. By contrast, according to Christian Wolff, there exists a duty to take care that both one's own and other political communities deserve to be esteemed. In his view, this duty is grounded in the duty of self‐perfection because the qualities for which communities deserve to be esteemed are those that promote the self‐perfection of individuals. From this perspective, he argues that duties of esteem toward political communities should not be seen as an outcome of power relations but rather as an outcome of the fulfillment of functions of the law of peoples. Wolff's line of argument draws attention to the possibility that anger over a violation of the desire for honor could be mistaken for an expression of specific culture‐specific sensitivities, while what really may be expressed is a diverging interpretation of the implications of dependence in international relations. [ABSTRACT FROM AUTHOR]

The readily available α‐diazo‐β‐oxosulfones have been employed, for the first time, in the Wolff cyclocondensation with aromatic amines promoted by 1.5‐fold excess of TiCl4. The reaction was found to be general (as illustrated by 15 product examples) and resulted in moderate yields of medicinally relevant sulfonyl 1,2,3‐triazoles. Excluding the Lewis acid promoter resulted in a clean and high‐yielding formation of α‐sulfonyl acetanilides resulting from the thermal Wolff rearrangement and trapping of the ketene intermediate with an aniline molecule. [ABSTRACT FROM AUTHOR]

Electrocardiographic findings including irregularity of the rhythm, a very rapid ventricular response, and the presence of a delta wave should raise the suspicion of pre‐excited atrial fibrillation with a rapid ventricular response. Urgent cardioversion is needed due to the risk of sudden cardiac death. [ABSTRACT FROM AUTHOR]

Quetiapine is occasionally associated with cardiovascular adverse effects such as QTc prolongation. QTc prolongation is a side effect that requires monitoring in order to avoid more serious cardiac complications. One particular understudied area is the potential for antipsychotics to elicit electroconduction abnormalities in patients with Wolff-Parkinson-White (WPW) Syndrome. In the present report, we describe a case of quetiapine overdose in a patient with WPW. [ABSTRACT FROM AUTHOR]

Olfactory neuropathy spectrum disorder is characterized by hyposmia or anosmia and hypoplastic or absent olfactory bulbs. There may be an association between olfactory neuropathy spectrum disorder and Wolff‐Parkinson‐White syndrome. [ABSTRACT FROM AUTHOR]

Aim: The objective of this article is to review the demographics, diagnostic criteria, etiopathogenesis, comorbidities and management of Wolff–Parkinson–White syndrome (WPWS). In addition, the relevant cardiovascular outcomes of published cases involving head and neck/oral and maxillofacial procedures were summarized. Materials and Methods: A search of the PubMed database, restricted to human studies published in the English language literature, was performed from 1960 through July 2021 for articles. Results: The search strategy yielded 24 patients, totalling 25 dates of treatment, with WPWS concordant with head and neck/oral and maxillofacial procedures, predominately involving biopsy, tumour resection and extractions; significantly, 5 of whom, experienced their first episode of WPWS while undergoing treatment of the head and neck. None of the procedures resulted in patient death. Conclusions: Practitioners should be familiar with the clinical features of WPWS and be prepared to manage emergent cardiovascular deterioration. Electrocardiogram monitoring of this cohort is advised during head and neck/oral and maxillofacial surgical procedures, particularly involving general anaesthesia. Breakthrough episodes of WPWS may still occur in patients who have previously undergone cardioconversion. [ABSTRACT FROM AUTHOR]

The first total synthesis of the Euphorbia diterpenoid pepluacetal is disclosed in both racemic and chiral fashions. The synthesis strategically relies on a photo‐induced Wolff rearrangement/lactonization cascade (WRLC) reaction to access the cyclobutane moiety, a ring‐closing metathesis/cyclopropanation sequence to rapidly forge the 7–3 bicyclic system, and a late‐stage Rh‐catalyzed transannular carbenoid insertion to C(sp3)−H bond followed by a Baeyer–Villiger oxidation and ring‐opening manipulations to install the side chain. The synthetic route demonstrates excellent stereochemical control on the non‐classical concave‐face bond formation, remote traceless stereochemical relay and high scalability to provide 20 mg of (+)‐pepluacetal. [ABSTRACT FROM AUTHOR]

Introduction. The relationship between ventricular pre-excitation and left ventricular dysfunction has been described in the absence of sustained supraventricular tachycardia in a series of case reports. However, there have been no systematic studies about the effect of ventricular pre-excitation on cardiac function in adult patients with different accessory pathway locations. Methods and Results. Patients were divided into four groups based on the type and location of their accessory pathway: septal, right free wall, left free wall, and concealed. N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, electrocardiogram recordings, electrophysiological properties, and transthoracic echocardiographic data (septal-to-posterior wall motion delay (SPWMD) and interventricular mechanical delay (IVMD) indicating intraventricular and interventricular dyssynchrony) were compared before and after successful ablation. Before radiofrequency catheter ablation, left ventricular ejection fraction (LVEF) was significantly lower in patients with septal and right free wall accessory pathways. Within three months after radiofrequency catheter ablation, NT-proBNP levels decreased, left ventricular function improved, and intraventricular left ventricular dyssynchrony disappeared. There was a negative correlation between initial LVEF with initial QRS duration and initial SPWMD. Notably, SPWMD had a stronger correlation with LVEF than initial QRS duration. Conclusions. Anterograde conduction with a septal or right free wall accessory pathway may cause left ventricular dyssynchrony and impair left ventricular function. Intraventricular left ventricular dyssynchrony seems to be responsible for the pathogenesis of left ventricular dysfunction. Radiofrequency catheter ablation results in decreased NT-proBNP levels, normalized QRS duration, mechanical resynchronization, and improved left ventricular function. [ABSTRACT FROM AUTHOR]

Syncope is a common manifestation of both hypertrophic cardiomyopathy (HCM) and Wolff-Parkinson-White (WPW) syndrome. The most common arrhythmia in HCM is ventricular tachycardia (VT) and atrial fibrillation (AF). While preexcitation provides the substrate for reentry and supraventricular tachycardia (SVT), AF is more common in patients with preexcitation than the general population. Concurrence of HCM and WPW has been reported in many cases, but whether the prognosis or severity of arrhythmia is different compared to the individual disorders remains unsettled. We report a case of HCM and Wolff-Parkinson-White (WPW) syndrome in a 28-year-old male Nigerian soldier presenting with recurrent syncope and lichen planus. [ABSTRACT FROM AUTHOR]

Gold‐catalyzed oxidations of alkynes by N‐oxides offer direct access to reactive α‐oxo gold carbene intermediates from benign and readily available alkynes instead of hazardous diazo carbonyl compounds. Despite various versatile synthetic methods developed based on this strategy, one of the hallmarks of α‐oxo carbene/carbenoid chemistry, that is, the Wolff rearrangement, has not been realized in this context. This study discloses the first examples that show the Wolff rearrangement can be readily realized by α‐oxo gold carbenes oxidatively generated from TBS‐terminated alkynes (TBS=tert‐butyldimethylsilyl). The thus‐generated silylketenes can be either isolated pure or subsequently trapped by various internal or external nucleophiles in one pot to afford α‐silylated carboxylic acids, their derivatives, or TBS‐substituted allenes. Avoiding hazard: The Wolff rearrangement is observed for the first time upon gold‐catalyzed oxidation of terminally TBS‐substituted alkynes. The silyl group is essential for this reaction, and the generated silylketenes are stable and can be either isolated or subsequently trapped in a variety of manners to afford γ‐lactones, α‐silylated carboxylic acids and their derivatives, or silylallenes. [ABSTRACT FROM AUTHOR]

Background: Wolff‐Parkinson‐White (WPW) syndrome is characterized by an anomalous accessory pathway (AP) that connects the atrium and ventricles, which can cause abnormal myocardial excitation and cardiac arrhythmias. The morphological and electrophysiological details of the AP remain unclear. The size and conductivity of the AP may affect conduction and WPW syndrome symptoms. Methods: To clarify this issue, we performed computer simulations of antegrade AP conduction using a simplified wall model. We focused on the bundle size of the AP and myocardial electrical conductivity during antegrade conduction (from the atrium to the ventricle). Results: We found that a thick AP and high ventricular conductivity promoted antegrade conduction, whereas a thin AP is unable to deliver the transmembrane current required for electric conduction. High ventricular conductivity amplifies transmembrane current. These findings suggest the involvement of a source‐sink mechanism. Furthermore, we found that high AP conductivity blocked antegrade conduction. As AP conductivity increased, sustained outward transmembrane currents were observed. This finding suggests the involvement of an electrotonic effect. Conclusions: The findings of our theoretical simulation suggest that AP size, ventricular conductivity, and AP conductivity affect antegrade conduction through different mechanisms. Our findings provide new insights into the morphological and electrophysiological details of the AP. [ABSTRACT FROM AUTHOR]

This article in Advanced Synthesis & Catalysis presents a green and efficient method for synthesizing fused pyrimidinediones using a cascade Wolff rearrangement and double N-acylation reaction. The protocol eliminates the need for catalysts and additives, as well as traditional purification methods like organic solvent extraction and column chromatography. The authors demonstrate the potential applications of this reaction by synthesizing biologically active molecules and conducting gram-scale experiments. The details of the protocol can be found in the communication by Yan-Ping Zhu, Wei Zhu, and their co-workers. [Extracted from the article]

The article presents a case study of a 69-year-old female who underwent an electrophysiological study due to recurrent supraventricular tachycardia (SVT). It highlighted the occurrence of a wide complex tachycardia (WCT) and explored the mechanism behind its transformation following a premature ventricular complex (PVC). Treatment discussed involved radiofrequency ablation targeting the base of the triangle of Koch, which successfully eliminated SVT inducibility and potentially the NFV pathway.

Background: Wolff‐Parkinson‐White syndrome is a congenital abnormality of the heart. Patients with this syndrome and multiple dental caries with pulp exposure may require comprehensive dental treatment under general anesthesia. Pulpectomy is performed in primary teeth with pulp expose. This treatment in anterior teeth requires palatal access and the majority there is no good visibility, requiring more time to perform. Therefore, this case aimed to demonstrate a pulp chamber opening alternative in pulpectomies in a child with Wolff‐Parkinson‐White syndrome. Case Presentation: A 3‐year‐old female patient with Wolff‐Parkinson‐White syndrome and multiple dental caries with reversible pulpitis in anterior upper teeth. The dental treatment was performed under general anesthesia. Due to abundant hemorrhage in anterior upper teeth, pulpectomies were performed, which pulp chamber openings were modified by labial and the treatment itself was completed. After, these teeth were rehabilitated with direct restorative veneers using light‐curing composite resin. The follow‐up at 12 months showed an absence of evidence clinic and radiographic. Conclusion: This case demonstrated the pulp chamber opening performed by labial in pulpectomy is an effective and viable alternative to reduce operative time and improve visibility in pulpotomies in a child with Wolff‐Parkinson‐White syndrome. [ABSTRACT FROM AUTHOR]

We show that if S={ft:Y→Y}t≥0$S=\lbrace f_{t}:Y\rightarrow Y\rbrace _{t\ge 0}$ is a one‐parameter continuous semigroup of nonexpansive mappings acting on a complete locally compact geodesic space (Y,d)$(Y,d)$ that satisfies some geometric properties, then there exists ξ∈∂Y$\xi \in \partial Y$ such that S converge uniformly on bounded sets of Y to ξ. In particular, our result applies to strictly convex bounded domains in Rn$\mathbb {R}^{n}$ or Cn$\mathbb {C}^{n}$ with respect to a large class of metrics including Hilbert's and Kobayashi's metrics. [ABSTRACT FROM AUTHOR]

The article presents the discussion on case study of 17-year-old healthy male with chest pain and intermittent episodes of shortness of breath. Topics include risk stratification and possible catheter ablation of AP due to the small but well-characterized risk of sudden death associated with asymptomatic pre-excitation; and ongenitally corrected transposition of the great arteries, and hypertrophic cardiomyopathy appears to confer a higher risk of multiple APs.

A visible‐light‐driven and room temperature photo‐Wolff‐Kischner reaction of sulfur ylides and N‐tosylhydrazones has been developed for the first time to provide modular access to alkene synthesis. The high functional group tolerance and broad substrate scope were demonstrated by more than 60 examples. Both E‐ and Z‐olefinic stereochemistry in the products could be controlled with excellent stereoselectivity. A series of mechanistic studies support that the reaction should proceed through a radical‐carbanion crossover pathway, specifically involving addition of photo‐generated sulfur ylide radical cations to N‐tosylhydrazones to form carbanions and subsequent Wolff‐Kischner process. [ABSTRACT FROM AUTHOR]

While this should act as a physical barrier between the iodine cap and catheter, there was evidence of bleeding of iodine into the catheter lumen between dialysis sessions (Fig. Severe iodine-induced hypothyroidism in an infant on peritoneal dialysis: A salient reminder of the Wolff-Chaikoff effect of iodine One such example is seaweed soup which is commonly ingested postpartum in some Asian cultures to promote breastmilk supply.[6] In PD, povidone-iodine 10% caps are placed on the end of dialysis catheters in between dialysis sessions to prevent infection. With the presence of iodine in the dialysate, iodine overload due to peritoneal exposure and absorption was determined to be the cause of hypothyroidism. [Extracted from the article]

Introduction: Acquired Wolff–Parkinson–White (WPW) syndrome can occur after congenital heart disease (CHD) surgery. Methods and Results: A 27‐year‐old male with Ebstein's anomaly and manifest WPW syndrome received catheter ablation twice. The first electrophysiology study (EPS) induced orthodromic atrioventricular reentrant tachycardia and successfully eliminated the posteroseptal accessory pathway (AP). Six months after the Cone procedure, the patient suffered from palpitation. The second EPS was performed and abolished the right lateral AP. Conclusion: The appearance of a new AP after the reconstruction of CHD is a rare finding and should raise suspicion of an acquired AP connection. [ABSTRACT FROM AUTHOR]

Background Risk stratification for Wolff-Parkinson-White (WPW) pattern either by noninvasive or invasive tests is important to determine whether an ablation is necessary or not. The aim was to compare noninvasive tests and invasive studies in a pediatric WPW population. Methods A total of 71 WPW patients (median age 14 years [interquartile range, 11-16 years]; 43 male) underwent Holter monitoring, exercise stress test (EST), and transesophageal electrophysiological study (TEEPS). In the case of a ≤270-ms effective refractory period of accessory pathway or induction of supraventricular tachycardia using TEEPS, patients were classified as high risk and underwent invasive electrophysiological study (EPS). Results Nine of 23 patients with low risk by Holter and eight of 26 patients with low risk by EST had high risk in TEEPS. Risky TEEPS results were detected in 42 of 71 patients and those patients underwent EPS. High-risk characteristic in EPS was detected in seven of nine patients with low risk by Holter and in seven of eight with low risk by EST. Both tests yielded moderate specificity (52-69%) and negative predictive value (61-69%) according to TEEPS. Conclusion Holter and EST have low predictive value in WPW risk stratification. However, TEEPS and EPS are extremely valuable in WPW risk stratification. TEEPS may reveal important and useful results for WPW risk determination, especially in small children not having undergone EPS in order to avoid its complications. [ABSTRACT FROM AUTHOR]

A visible‐light‐induced highly practical catalyst‐free Wolff rearrangement/domino [4+2] cycloaddition of 2‐benzothiazolimines with α‐diazo ketones has been developed. This protocol provides a concise and facile synthetic approach to construct a broad range of benzothiazolopyrimidine derivatives bearing a quaternary carbon center under mild reaction conditions with high isolated yields and excellent diastereoselectivities (up to >99% yield and >20 : 1 d.r.). [ABSTRACT FROM AUTHOR]

Introduction: Herein, we present a rare case of the successful ablation of an accessory pathway (AP) involving the Marshall Bundle (MB) and coronary sinus musculature (CSM) in a 40‐year‐old man with Wolff−Parkinson−White syndrome. Methods and Results: An orthodromic reciprocating tachycardia (ORT) was inducible with the earliest atrial activation site located at the posterolateral mitral annulus. The local conduction and the cycle length of ORT was prolonged by peri‐mitral ablation; however, it failed to block the AP. The atrial insertion of the AP was identified by remapping during ORT at the left atrial ridge, which was away from the mitral annulus, where ablation was successful. Together with the electrophysiological findings in CSM potentials, we conclude that the epicardial MB‐CSM connection functioned as the AP in this patient. Conclusion: The novel variant form of AP comprised of MB and CSM should be noted. The atrial insertion of the MB may be the target of catheter ablation. [ABSTRACT FROM AUTHOR]

This is a case of antidromic AVRT in a patient with unapparent preexcitation, and we could successfully diagnose and treat with the careful interpretation of wide QRS tachycardia. We should keep in mind that differentiation between intermittent and unapparent preexcitation is difficult, and some patients with unapparent preexcitation have short refractory periods of those accessory pathways, leading to sudden death. [ABSTRACT FROM AUTHOR]

Abstract: Background: Successful ablation sites in Wolff‐Parkinson‐White syndrome (WPW) are characterized by short atrioventricular (AV) intervals. Approximately 15% of patients with WPW have adenosine‐sensitive accessory pathways (APs). We sought to determine if local AV intervals of adenosine‐sensitive APs are different from those of adenosine‐insensitive APs in patients with WPW. Methods: Patients ≤21 years with WPW and adenosine‐sensitive APs who underwent successful ablation over a 9‐year period were included. Patients with WPW and adenosine‐insensitive APs were matched by age and weight in a 1:2 case‐control design. AP location, antegrade and retrograde conduction properties, supraventricular tachycardia (SVT) inducibility, local AV interval, interval from delta wave onset to local ventricular activation (del‐V), and time to loss of preexcitation were reviewed. Results: Fourteen patients with adenosine‐sensitive APs and 28 with adenosine‐insensitive APs were included. Patients with adenosine‐sensitive APs had minimum 1:1 antegrade AP conduction at a longer median paced cycle length (380, interquartile range [IQR] 295 to 585 ms vs 290, IQR 250 to 330 ms, P = 0.046), were less likely to have inducible SVT (35.7% vs 75.0%, P = 0.035), and had a longer median local AV interval (40.5, IQR 30.8 to 58.3 ms vs 32.0, IQR 29.3 to 37.8 ms, P = 0.029) when compared to those with adenosine‐insensitive APs. Conclusion: Patients with WPW and adenosine‐sensitive APs have 1:1 antegrade AP conduction at longer cycle lengths, lower likelihood of SVT induction, and longer local AV intervals when compared to those with adenosine‐insensitive APs. In patients with WPW, it may be important to consider adenosine response when selecting appropriate ablation targets. [ABSTRACT FROM AUTHOR]

The microwave‐assisted direct coupling of 2‐alkynyl‐anilines/phenols and diazo ketones through Wolff rearrangement, intramolecular 1,4‐addition and nucleophile assisted fragmentation to synthesize functionalized 2‐quinolinones and coumarins are reported. This one‐pot manipulation features a short reaction time, high synthetic efficiency and broad substrate scope. [ABSTRACT FROM AUTHOR]

Purpose: To compare the efficacy, safety, and cost-effectiveness of a three-catheter approach with a conventional five-catheter approach for the mapping and ablation of supraventricular tachycardia in pediatric patients with Wolff-Parkinson-White Syndrome (WPW) and concealed accessory pathways (APs). Methods: A retrospective review from 2008 to 2012 of patients less than 21 years with WPW who underwent a three-catheter radiofrequency (RF) ablation of a left-sided AP (ablation, right ventricular [RV] apical, and coronary sinus [CS] decapolar catheters) was performed. The three-catheter group was compared to a control group who underwent a standard five-catheter (ablation, RV apical, CS decapolar, His catheter, and right atrial catheter) ablation for the treatment of left-sided WPW or concealed AP. Demographics, ablation outcomes, and costs were compared between groups. Results: Twenty-eight patients met inclusion criteria with 28 control patients. The groups did not differ in gender, age, weight, or body surface area. Locations of theAP on the mitral annulus were similar between the groups. All patients were ablated via transseptal approach. Note that 28 of 28 in the three-catheter group (100%) and 27 of 28 (96%) controls were acutely successfully ablated (P = 0.31). No complications were encountered. There was no difference in procedural time, time to loss of AP conduction, or number of RF applications. Use of the three-catheter technique resulted in a total savings of $2,465/case, which includes the $680 savings from using fewer catheters as well as the savings from a shortened procedure time. Conclusions: Ablation in patients withWPW and a left-sided AP can be performed using three catheters with similar efficacy and safety while offering significant cost savings compared to a conventional fivecatheter approach. [ABSTRACT FROM AUTHOR]

Introduction: Williams syndrome (WS) cases have been reported to have with 25–100 times greater increased risk of sudden cardiac death (SCD). SCD has been reported in cases without any evidence of structural cardiovascular anomalies. Wolff–Parkinson–White (WPW) syndrome is characterized by short PR interval and delta wave. Ventricular preexcitations can develop paroxysmal reentrant tachycardia through Kent bundle or less frequent atrial fibrillation and in some cases with accessory pathway effective refractory period (APERP) under 250 ms considered as risky and may lead to SCD. WS associated with WPW has not been reported before. Case Report: An 11‐year‐old male who had been followed up with WS was referred to pediatric cardiology outpatient clinic with the complaint of palpitation. Electrocardiographic examination showed short PR interval and delta wave in the ECG consistent with WPW. He underwent electrophysiological study (EPS). Basic measurements were performed, and APERP was found at 280 ms cycle atrial pacing. RF energy was delivered using a 4 mm tip nonirrigated radiofrequency (RF) ablation catheter where the best ventriculoatrial (VA) signals were received and the AP was abolished within few seconds. Discussion and Conclusions: Although, WPW cases are usually asymptomatic or related to SVT, the risk of SCD should not be ignored. Thus, all patients with WPW deserve an EPS for assessing the AP conduction properties. Due to the increased risk of SCD in patients with WS compared to general population, in the presence of concomitant WPW, these patients should be evaluated with EPS even if they do not have symptoms. [ABSTRACT FROM AUTHOR]

Wolff-Parkinson-White (WPW) syndrome is a conduction disturbance in which atrial impulses are transmitted to the ventricles by an accessory pathway instead of the normal atrioventricular conduction. The WPW syndrome may either simulate myocardial infarction or mask the electrocardiographic abnormalities of an acute MI. However, concealed WPW revealed after an acute coronary syndrome is rare with few cases reported in the literature. This article reports a case of coronary artery disease with ST-segment elevation in a 57-year-old man, previously asymptomatic, with an initial electrocardiogram showing no conduction abnormalities that subsequently presented with an ECG compatible with WPW. [ABSTRACT FROM AUTHOR]

Introduction: Accessory atrioventricular pathways (APs) may mediate atrioventricular reciprocating tachycardia and, in some cases, have the potential to conduct atrial tachycardia rapidly, which can be life threatening. While catheter ablation can be curative, ablation of right free wall APs is associated with a high rate of recurrence, likely secondary to reduced catheter stability along the right free wall atrioventricular groove. We sought to identify characteristics associated with a lower rate of recurrence and hypothesized ablation lesions placed on the ventricular side of the atrioventricular groove using a retroflexed catheter approach would decrease rates of recurrence. Methods and Results: Retrospective chart review of patients who underwent catheter ablation of a right free wall AP from January 1, 2008 through June 1, 2021 with >2 months follow up. Cox proportional hazards regression was used to identify relationships between predictor variables and AP recurrence. We identified 95 patients who underwent ablation of 98 right free wall APs. Median age was 13.1 years and median weight at ablation was 52.3 kg. Overall, 23/98 (23%) APs recurred. Use of a retroflexed catheter course approaching the atrioventricular groove from the ventricular aspect was associated with reduced risk of AP recurrence with (univariable hazard ratio of 0.10 [95% confidence interval: 0.01–0.78]), which remained significant in multiple two variable Cox proportional hazards models. Conclusion: Use of a retroflexed catheter course is associated with a reduced likelihood of AP recurrence. This approach results in improved catheter stability and should be considered for ablation of right free wall APs. [ABSTRACT FROM AUTHOR]

Background: Intermittent ventricular pre‐excitation was considered a low‐risk marker for sudden death. However, to date, some studies do not exclude the existence of accessory pathways (APs) with high‐risk intermittent antegrade conductive properties. According to current European Guidelines, high‐risk features of APs are antegrade pathway conduction ≤250 ms in baseline or during the adrenergic stimulus, inducibility of atrioventricular reciprocating tachycardias (AVRT), inducibility of pre‐excited atrial fibrillation (AF), and presence of multiple APs. For all of these transcatheter ablation is recommended. The aim of our study was to evaluate the existence of differences in risk characteristics between patients with intermittent pre‐excitation (IPX) and those with persistent pre‐excitation (PPX), from a sample of adults with ventricular pre‐excitation and symptoms like palpitations. Methods: 293 adults [IPX: 51 (17.4%); PPX: 242 (82.6%)] underwent electrophysiological study and then catheter ablation of their APs if arrhythmia inducibility (AVRT/AF) was noted, or, conversely, if it was appreciated a fast AP antegrade conduction, in baseline or during intravenous isoproterenol infusion, or if multiple APs were detected. Results: There were no statistically significant differences in demographic characteristics (age and gender), AVRT/AF inducibility, antegrade conductive properties, the prevalence of multiple APs, and APs locations between IPX and PPX patients. Conclusions: In our study, patients with IPX did not show significant differences in clinical and electrophysiological features versus PPX patients. [ABSTRACT FROM AUTHOR]