The predictive value of electrophysiologic studies in untreated patients with Wolff-Parkinson-White syndrome
Open accessAbstract
The ability of invasive electrophysiologic studies to predict future arrhythmic events in patients with minimally symptomatic Wolff-Parkinson-White syndrome is not known. To assess this ability, 42 patients with evidence of atrioventricular (AV) pre-excitation on the surface electrocardiogram underwent electrophysiologic studies and were then followed up as outpatients taking no medications. The patients were classified into three groups on the basis of prestudy symptoms: group I, 15 asymptomatic patients; group II, 10 patients with infrequent symptoms but no documented arrhythmias; and group III, 17 patients with one documented episode of supraventricular tachycardia or atrial fibrillation, or both. At electrophysiologic study, the number of patients with short anterograde accessory pathway effective refractory periods and rapid ventricular responses during induced atrial fibrillation did not differ statistically among the three groups. During a mean follow-up period of 7.5 +/- 4.9 years, 11 of the 42 patients had documented arrhythmias: 2 patients from group II and 2 patients from group III had supraventricular tachycardia and 7 patients from group III had atrial fibrillation. All nine patients from group III with subsequent arrhythmias had had clinical atrial fibrillation before study. No patient from group I had an arrhythmia during follow-up. There were no episodes of ventricular fibrillation or sudden cardiac death during follow-up in any of the patients. The only predischarge variables that correlated with the subsequent occurrence of arrhythmias were a history of documented arrhythmias before electrophysiologic study (p less than 0.01) and inducible supraventricular tachycardia at electrophysiologic study (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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In early studies, predictors of ventricular fibrillation in WPW syndrome were an R-R interval during spontaneous or induced AF below 180 ms, a history of symptomatic tachycardia, inducibility of AVRT, and multiple accessory pathways.
“In early studies, identified predictors of ventricular fibrillation in patients with WPW syndrome were R-R interval during spontaneous or induced AF , 180 ms, history of symptomatic tachycardia and inducibility of AVRT, and multiple accessory pathways.308,309”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [308]
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- Authors
- Beckman, K. J., Gallastegui, J. L., Bauman, J. L., & Hariman, R. J.
- Affiliations
- University of Illinois Chicago (US)
- Corresponding author
- Beckman, Karen J.
- ORCID
- Bauman, Jerry L.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 1990-03
- Volume
- 15
- Issue
- 3
- Pages
- 640-647
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2071247280
- Cited by
- 56
- References
- 28
- Citations by year
- 2021: 1 · 2020: 1 · 2019: 1 · 2017: 2 · 2016: 1 · 2015: 8 · 2014: 1 · 2013: 1 · 2012: 6
- FWCI
- 2.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- Wolff-Parkinson-White syndrome, electrophysiological study, arrhythmia prediction, supraventricular tachycardia, atrial fibrillation, sudden cardiac death, asymptomatic patients, risk stratification, screening
- MeSH terms
- Adolescent, Adult, Arrhythmias, Cardiac, Electrophysiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Predictive Value of Tests, Tachycardia, Supraventricular, Wolff-Parkinson-White Syndrome, Incidence
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