Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Accessory atrioventricular pathways with only antegrade conduction in patients with symptomatic Wolff-Parkinson-White syndrome
Clinical features, electrophysiological characteristics and response to radiofrequency catheter ablation
*Shin-Kong Memorial Hospital Taipei, Taiwan, R.O.C.
Division of Cardiology, Department of Medicine, National Yang-Ming University, and Veterans General Hospital-Taipei and Kaohsiung Taiwan, R.O.C.
revised 20 March 1996; accepted 20 March 1996.
Correspondence: Shih-Ann Chen, MD, Division of Cardiology, Veterans General Hospital-Taipei. 201 Sec 2, Shih-Pai Road, Taipei, Taiwan, R.O.C.
Abstract
Information about accessory pathways conducting only in the antegrade direction is limited. The purposes of the present study were to prospectively investigate the clinical features, electrophysiological characteristics, effects of radiofrequency catheter ablation and recurrent atrial fibrillation after successful ablation in patients with accessory pathways conducting only in the antegrade direction, and to compare them with those who had pathways capable of bidirectional conduction in a consecutive series of 759 patients.
Electrophysiological studies and radiofrequency catheter ablation were performed in 33 study patients with antegrade-only accessory pathways and in 377 patients with bidirectional accessory pathways for comparison. The patients with accessory pathways conducting only in the antegrade direction were older (47±16 vs 40±16 years, P=0·037) and had a higher incidence of atrial fibrillation (100% vs 27·1%, P<0·001) as well as related syncope (33·3% vs 10·1%, P=0·001). The study patients also had more accessory pathways located in the posterior septum and a higher incidence of retrograde atrioventricular nodal conduction. The biophysical variables, success and complication rates of radiofrequency ablation were similar in both groups. During the follow-up period of 32±12 months, symptomatic atrial fibrillation after successful ablation did not recur in 79% and 81% of patients with unidirectional and bidirectional accessory pathways, respectively. Furthermore, old age and cardiovascular diseases were independent predictors of recurrent atrial fibrillation after radiofrequency ablation.
In conclusion, this study showed that atrial fibrillation with preexcitation was the usual presentation in patients who had symptomatic Wolff-Parkinson-White syndrome with an antegrade-only accessory pathway, and might be related to antegrade conduction of the accessory pathway. Therefore elimination of antegrade-only and bidirectional pathways by radiofrequency ablation could prevent the recurrence of symptomatic atrial fibrillation in younger patients without cardiac disease.
Key Words: Accessory pathway • antegrade conduction • radiofrequency • catheter ablation
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. N. Levine, M. J. Kern, P. B. Berger, D. L. Brown, L. W. Klein, D. J. Kereiakes, T. A. Sanborn, A. K. Jacobs, and for the American Heart Association Diagnostic and Management of Patients Undergoing Percutaneous Coronary Revascularization Ann Intern Med, July 15, 2003; 139(2): 123 - 136. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Oddsson, N. Edvardsson, and H. Walfridsson Episodes of atrial fibrillation and atrial vulnerability after successful radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome Europace, January 1, 2002; 4(2): 201 - 206. [Abstract] [Full Text] [PDF]
|
|