The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.
Longitudinal Electrophysiologic Assessment of Asymptomatic Patients with the Wolff–Parkinson–White Electrocardiographs Pattern
Abstract
Although most asymptomatic patients with the Wolff-Parkinson-White electrocardiographic pattern have a good prognosis, some die suddenly. The mechanism of sudden death is usually ventricular fibrillation, which is triggered by atrial fibrillation with a rapid ventricular response rate. Electrophysiologic testing has been proposed to identify asymptomatic patients who may be at risk for sudden death. Meaningful application of such testing requires a knowledge of whether the electrophysiologic measurements are reproducible over time. Consequently, we performed electrophysiologic studies on two occasions at least 36 months apart (mean +/- SD, 54.7 +/- 14) in 29 asymptomatic patients with the pattern. Twenty-seven patients remained asymptomatic, and sustained supraventricular tachycardia developed in two during the follow-up period. Nine patients (31 percent) lost the capacity for preexcitation and anterograde conduction over the accessory pathway, which produces the Wolff-Parkinson-White pattern. The others had little change in measurements of conduction over the accessory pathway. Patients who lost conduction over the accessory pathway tended to be older (mean +/- SD, 50 +/- 18 vs. 39 +/- 11 years; P = 0.06) than patients who retained preexcitation, and they had longer anterograde effective refractory periods at the first assessment (414 +/- 158 vs. 295 +/- 27 msec; P = 0.003). We conclude that a considerable number of asymptomatic patients with the Wolff-Parkinson-White pattern lose their capacity for anterograde conduction over the accessory pathway. This loss of capacity probably contributes to the low mortality among asymptomatic patients.
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“Several randomized and observational studies indicate that in the asymptomatic WPW population risk stratification using an invasive electrophysiological testing may be beneficial (Table 17).322,336,337,339,341,343”
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 [337]
Citations
Cites
Ventricular fibrillation in the Wolff-Parkinson-White syndrome
Klein, G. J., Bashore, T. M., Sellers, T. D., Pritchett, E. L. C., Smith, W. M., & Gallagher, J. J. (1979) · New England Journal of Medicine · doi:10.1056/nejm197911153012003 · Cited by 830
Self-citationIntermittent preexcitation in the wolff-parkinson-white syndrome
Klein, G. J., & Gulamhusein, S. S. (1983) · The American Journal of Cardiology · doi:10.1016/0002-9149(83)90125-x · Cited by 172
Self-citationMilstein, S., Sharma, A. D., Guiraudon, G. M., & Klein, G. J. (1987) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1987.tb04520.x · Cited by 166
Self-citationThe Wolff–Parkinson–White Electrocardiogram
BERKMAN, N. L., & Lamb, L. E. (1968) · New England Journal of Medicine · doi:10.1056/nejm196802292780906 · Cited by 120
Electrophysiologic profile of asymptomatic Wolff-Parkinson-White pattern
Milstein, S., Sharma, A. D., & Klein, G. J. (1986) · The American Journal of Cardiology · doi:10.1016/0002-9149(86)90681-8 · Cited by 98
Self-citationWOLFF‐PARKINSON‐WHITE SYNDROME
Flensted-Jensen, E. (1969) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1969.tb01441.x · Cited by 94
Wolff-Parkinson-White syndrome. A long-term follow-up of 47 cases.
Flensted-Jensen, E. (1969) · PubMed · Cited by 83
The Wolff-Parkinson-White Syndrome as an Aviation Risk
Smith, R. F. (1964) · Circulation · doi:10.1161/01.cir.29.5.672 · Cited by 79
Klein, G. J., Hackel, D. B., & Gallagher, J. J. (1980) · Circulation · doi:10.1161/01.cir.61.6.1249 · Cited by 68
Self-citationPre-excitation syndrome: Facts and theories
(1980) · American Heart Journal · doi:10.1016/0002-8703(80)90298-7 · Cited by 24
Fujiki, A., Yoshida, S., Tani, M., & Sasayama, S. (1988) · Journal of Electrocardiology · doi:10.1016/s0022-0736(88)80027-x · Cited by 10
Research works printed but not linked: 2
- Guize, 1985, Ann Med Interne (Paris), 136, 474
- Gillette, 1980, Circulation, 62, III-271
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Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A. M., Field, M. E., Goldberger, Z. D., Hammill, S. C., et al. (2016) · Circulation · doi:10.1161/cir.0000000000000311 · Cited by 595
2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia
Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A. M., Field, M. E., Goldberger, Z. D., Hammill, S. C., et al. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.08.856 · Cited by 439
Supraventricular tachycardia mechanisms and their age distribution in pediatric patients
Ko, J. K., Deal, B. J., Strasburger, J. F., & Benson, D. W. (1992) · The American Journal of Cardiology · doi:10.1016/0002-9149(92)90858-v · Cited by 402
Cohen, M. I., Triedman, J. K., Cannon, B. C., Davis, A. M., Drago, F., Janoušek, J., Klein, G. J., Law, I. H., Morady, F., Paul, T., et al. (2012) · Heart Rhythm · doi:10.1016/j.hrthm.2012.03.050 · Cited by 379
Self-citationPerry, J. C., & Garson, A. (1990) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(90)90555-4 · Cited by 316
Metadata
- Authors
- Klein, G. J., Yee, R., & Sharma, A. D.
- Affiliations
- London Health Sciences Centre (CA)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1989-05-11
- Volume
- 320
- Issue
- 19
- Pages
- 1229-1233
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2340334067
- Cited by
- 156
- References
- 11
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 7 · 2016: 3 · 2015: 13 · 2014: 3 · 2013: 4 · 2012: 10
- FWCI
- 6.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (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 › Cardiac pacing and defibrillation studies
- Keywords
- Wolff-Parkinson-White syndrome, asymptomatic patients, accessory pathway, preexcitation, effective refractory period, sudden cardiac death, ventricular fibrillation, atrial fibrillation, supraventricular tachycardia
- MeSH terms
- Atrial Fibrillation, Electrocardiography, Female, Heart Conduction System, Humans, Longitudinal Studies, Male, Middle Aged, Refractory Period, Electrophysiological, Ventricular Fibrillation, Wolff-Parkinson-White Syndrome
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