Electrophysiologic evaluation of asymptomatic patients with the Wolff-Parkinson-White pattern
Abstract
In the past 4 years, 34 asymptomatic patients with the Wolff-Parkinson-White (WPW) pattern underwent electrophysiologic study. The effective refractory period (ERP) of antegrade conduction over the accessory pathway was 288 +/- 29 msec. In three asymptomatic patients (9%), the antegrade ERP of the accessory pathway was shorter than 250 msec. The antegrade ERP of the accessory pathway became shorter than 250 msec in an additional 12 of 22 (55%) patients after isoproterenol administration. Nineteen (56%) of the asymptomatic patients showed the absence of retrograde conduction over the accessory pathway even after isoproterenol administration. The rate of induction of orthodromic reciprocating tachycardia in the asymptomatic WPW patients was 15% (5/34), which was significantly lower than that in the symptomatic patients. These data suggest that in the asymptomatic patients, the absence of retrograde conduction over the accessory pathway is the reason they remained asymptomatic, free of reciprocating tachycardia. However, even in the asymptomatic patients, some had the accessory pathway in which antegrade ERP was shorter than 250 msec. They may result in rapid ventricular conduction over the accessory pathway when atrial fibrillation develops.
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Several randomized and observational studies indicate that risk stratification using invasive electrophysiological testing may be beneficial in the asymptomatic WPW population.
“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 [336]
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- Authors
- SATOH, M., AIZAWA, Y., FUNAZAKI, T., NIWANO, S., EBE, K., MIYAJIMA, S., SUZUKI, K., AIZAWA, M., & SHIBATA, A.
- Affiliations
- Niigata University (JP)
- Corresponding author
- SATOH, MASAHITO
- Venue
- Pacing and Clinical Electrophysiology
- Publisher
- Wiley
- Published
- 1989-03
- Volume
- 12
- Issue
- 3
- Pages
- 413-420
- ISSN
- 0147-8389 (ISSN-L)
- 1540-8159
- OpenAlex
- W2046098350
- Cited by
- 46
- References
- 16
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 1 · 2021: 3 · 2020: 1 · 2016: 1 · 2015: 11 · 2014: 3 · 2013: 1 · 2012: 7
- FWCI
- 0.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pacing and Clinical Electrophysiology (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, effective refractory period, isoproterenol, retrograde conduction, orthodromic reciprocating tachycardia, atrial fibrillation, ventricular conduction
- MeSH terms
- Adult, Cardiac Pacing, Artificial, Electrocardiography, Electrophysiology, Female, Heart Conduction System, Humans, Isoproterenol, Male, Wolff-Parkinson-White Syndrome
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