+ Translate

Electrophysiological evaluation of the different degrees of risk of high frequency atrial fibrillation in wpw syndrome

, : Electrophysiological evaluation of the different degrees of risk of high frequency atrial fibrillation in wpw syndrome. Giornale Italiano di Cardiologia 17(2): 127-133

Sudden death in WPW pattern can occur when atrial fibrillation (a.f.) with rapid ventricular response develops. This event seems to be the final result of three concomitant conditions: 1) the appearance of an ortodromic atrio-ventricular reciprocating tachycardia, the most common form of tachycardia in these patients; 2) a high atrial vulnerability, which makes possible that reciprocating tachycardia degenerates into atrial fibrillation and 3) a short anterograde refractory period of the Kent bundle. With the purpose of evaluating the risk to develop high frequency a.f., 36 WPW subjects were electrophysiologically studied. 22 were symptomatic for palpitations (Group 1)and 14 were totally asymptomatic (Group II). 3/22 patients of Group I had experienced clinical atrial fibrillation (Subgroup I A), which was never documented in the remaining 19/22 (Subgroup I B). In all cases the following parameters were analyzed: 1) the presence or absence of the retrograde conduction of the anomalous pathways, essential for the occurrence of orthodromic reciprocating atrioventricular tachycardia; 2) the presence or absence of a high atrial vulnerability and 3) the presence of RR intervals between prexcited complexes during induced a.f. < 250 msec. As an index of atrial vulnerability were considered a) the spontaneous degeneration into atrial fibrillation of an electrophysiologically induced reciprocating tachycardia and/or b) the induction of a sustained a.f. by programmed right atrial stimulation during sinus rhythm and/or during 600 and 400 ms atrial driving and/or by 160-250/m' atrial bursts. Results: Retrograde conduction of Kent bundle was documented in 100% of Gr.I vs 22% of Gr. II (p < 0.001). A reciprocating atrio-ventricular tachycardia was induced in 77% of Gr. I vs 14% of Gr. II (p < 0.001), which was sustained (.gtoreq. 1 min) in 59% of Gr. I and in no case of Gr. II. A high atrial vulnerability was documented in 41% of Gr. I (100% and 31% in subgroups IA and IB respectively) vs. 22% of Gr. II (NS). RR intervals between preexcited complexes during a.f. < 250 ms were noted in 41% of Gr. I vs 22% of Gr. II (NS). The concomitance of a) retrograde conduction of Kent bundle + b) high atrial vulnerability + c) shortest RR intervals during a.f. < 250 ms was demonstrated in 27% of Gr. I (21% in subgroup I B) and in no case of Gr. II. Conclusions: Our data suggest that, on the basis of a poliparametric electrophysiologic evaluation, about 1/5 of symptomatic WPW patients is predisposed to develop high frequency atrial fibrillation while this possibility seems very unlikely in asymptomatic subjects. It follows that while electrophysiologic study is mandatory in symptomatic patients to recognize the ones at higher risk of rapid atrial fibrillation, this procedure does not seem always necessary in asymptomatic subjects.

(PDF 0-2 workdays service)

Accession: 005349615

Submit PDF Full Text: Here

Submit PDF Full Text

No spam - Every submission is manually reviewed

Due to poor quality, we do not accept files from Researchgate

Submitted PDF Full Texts will always be free for everyone
(We only charge for PDFs that we need to acquire)

Select a PDF file:

Related references

Delise, P.; D'Este, D.; Bonso, A.; Raviele, A.;, F.; Millosevich, P.; Livio, A.; Piccolo, E., 1987: Different degrees of risk of high-frequency atrial fibrillation in symptomatic and asymptomatic WPW syndrome. Electrophysiologic evaluation. Sudden death in WPW pattern can occur when atrial fibrillation (a.f.) with rapid ventricular response develops. This event seems to be the final result of three concomitant conditions: the appearance of an orthodromic atrio-ventricular reciprocati...

Chang, S-Lin.; Chen, Y-Chang.; Hsu, C-Po.; Kao, Y-Hsun.; Lin, Y-Kuo.; Lin, Y-Jiang.; Wu, T-Juey.; Chen, S-Ann.; Chen, Y-Jen., 2014: Electrophysiological characteristics of complex fractionated electrograms and high frequency activity in atrial fibrillation. It is unclear whether atrial substrate with complex fractionated electrograms (CFAEs) is related to arrhythmogenesis. This study aimed to investigate the electrophysiology in CFAE and high dominant frequency (DF) areas. Atrial fibrillation (AF) wa...

Masson, S.; Aleksova, A.; Favero, C.; Staszewsky, L.; Bernardinangeli, M.; Belvito, C.; Cioffi, G.; Sinagra, G.; Mazzone, C.; Bertocchi, F.; Vago, T.; Peri, G.; Cuccovillo, I.; Masuda, N.; Barlera, S.; Mantovani, A.; Maggioni, A.P.; Franzosi, M.Grazia.; Disertori, M.; Latini, R.; Rossi, M.G.; Fazi, A.; Pierfelice, O.; Gavazzi, A.; Taddei, F.; Rigatelli, G.; Boni, S.; Trappolin, R.; Muscella, A.; Vetrano, A.; Gulizia, M.; Francese, G.M.; Perticone, F.; Severini, D.; Pirelli, S.; Spotti, A.; Maria, 2011: Predicting atrial fibrillation recurrence with circulating inflammatory markers in patients in sinus rhythm at high risk for atrial fibrillation: data from the GISSI atrial fibrillation trial. Inflammation may play a significant role in the pathogenesis of atrial fibrillation (AF). To examine the roles of three systemic inflammatory markers in predicting recurrent AF. The association between the plasma concentrations of high-sensitivity...

Healey, J.S.; Israel, C.W.; Connolly, S.J.; Hohnloser, S.H.; Nair, G.M.; Divakaramenon, S.; Capucci, A.; Van Gelder, I.C.; Lau, C-Pak.; Gold, M.R.; Carlson, M.; Themeles, E.; Morillo, C.A., 2012: Relevance of electrical remodeling in human atrial fibrillation: results of the Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial mechanisms of atrial fibrillation study. In animal models of atrial fibrillation (AF), changes in atrial electrophysiological properties are associated with the development of AF. Their relevance to human AF is unclear. and Results-The Asymptomatic Atrial Fibrillation and Stroke Evaluati...

Illien, S.; Schmidt, H.; Hammerstingl, C.; Maroto Jaervinen, S.; Von Der Recke, G.; Luederitz, B.; Omran, H., 2001: Thromboembolic risk in atrial fibrillation Does transesophageal echocardiographic risk assessment of patients with atrial fibrillation add to clinical risk factor evaluation?. European Heart Journal 22(Abstract Supplement): 189, September

Gondo, N.; Kumagai, K.; Matsuo, K.; Annoura, M.; Moroe, K.; Arakawa, K., 1994: Electrophysiological properties in paroxysmal atrial fibrillation complicated with the Wolff-Parkinson-White syndrome: comparison with paroxysmal atrial fibrillation alone. Electrophysiological studies were performed in 26 patients with atrial fibrillation (AF). Thirteen patients had the Wolff-Parkinson-White (WPW) syndrome (group A), and another 13 patients did not have the WPW syndrome (group B). The right atrium e...

Dagres, N.; Clague, J.R.; Lottkamp, H.; Hindricks, G.; Breithardt, G.; Borggrefe, M., 2001: Impact of radiofrequency catheter ablation of accessory pathways on the frequency of atrial fibrillation during long-term follow-up; high recurrence rate of atrial fibrillation in patients older than 50 years of age. Aims Atrial fibrillation represents a frequent and potentially life-threatening arrhythmia in patients with accessory atrioventricular pathways. Radiofrequency ablation has become the curative treatment of first choice for these patients. Investig...

Muraoka, Y.; Karakawa, S.; Yamagata, T.; Matsuura, H.; Kajiyama, G., 1998: Dependency on atrial electrophysiological properties of appearance of paroxysmal atrial fibrillation in patients with Wolff-Parkinson-White syndrome: evidence from atrial vulnerability before and after radiofrequency catheter ablation and surgical cryoablation. The pathogenesis of paroxysmal atrial fibrillation in patients with Wolff-Parkinson-White syndrome and the effects of elimination of accessory pathways on the appearance of atrial fibrillation are still controversial. Fifty-four patients with Wolf...

Konoe A.; Tanigawa M.; Mori M.; Kadena M.; Hashimoto T.; Isomoto S.; Sakamoto T.; Fukatani M.; Hashiba K., 1990: Electrophysiological abnormalities of the atrial muscle in patients with wolff parkinson white syndrome and paroxysmal atrial fibrillation. Japanese Circulation Journal 54(7): 823-823

Padeletti L.; Michelucci A.; Giovannini T.; Mezzani A.; Monopoli A.; Franchi F., 1989: Paroxysmal atrial fibrillation evaluation of local electrophysiological properties at five atrial sites. Programmed atrial stimulation at five atrial sites was performed to evaluate electrophysiologic atrial properties in 17 control patients (14 M, 3 F, mean age 61 .+-. 9 years) (Group A) and in 18 patients with paroxysmal atrial fibrillation (13 M,...