Clinical characteristics and electrophysiologic properties of atrioventricular accessory pathways: importance of the accessory pathway location.
Details
Serval ID
serval:BIB_6CB1C8316AEB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical characteristics and electrophysiologic properties of atrioventricular accessory pathways: importance of the accessory pathway location.
Journal
Journal of the American College of Cardiology
ISSN
0735-1097
Publication state
Published
Issued date
1992
Peer-reviewed
Oui
Volume
20
Number
3
Pages
666-671
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
OBJECTIVES. This study was designed to assess the influence of accessory atrioventricular (AV) pathway location on the clinical and electrophysiologic characteristics of 384 consecutive symptomatic patients having a single accessory pathway. METHODS. Four locations were studied: left free wall (n = 270), posteroseptal (n = 52), anteroseptal (n = 29) and right free wall (n = 33). Ten clinical variables and 12 electrophysiologic variables were analyzed, including the effective refractory period of the accessory pathway and the different clinically occurring and inducible arrhythmias. RESULTS. Only two clinical findings were associated with accessory pathway location: 1) later age at onset of symptoms in the left free wall versus other accessory pathway locations (24 +/- 12 vs. 20 +/- 11 years, p = 0.02), and 2) later age at the time of electrophysiologic study in the left free wall accessory pathway location (36 +/- 13 vs. 32 +/- 11 years, p = 0.01). Six electrophysiologic variables showed a correlation with the accessory pathway location: 1) retrograde conduction only was found less frequently in right free wall (9%) and anteroseptal (10%) than in left free wall (26%) and posteroseptal (29%) accessory pathway locations (p = 0.05); 2) the retrograde effective refractory period of the accessory pathway was shorter in anteroseptal (253 +/- 52 ms) and left free wall (270 +/- 72 ms) as compared with right free wall (296 +/- 101 ms) and posteroseptal (301 +/- 76 ms) locations (p = 0.05); 3) retrograde decremental conduction over the accessory pathway was present in the posteroseptal (17%) and left free wall (3%) but absent in the other locations (p less than 0.001); 4) anterograde decremental conduction was only seen in the right free wall location (12%) (p less than 0.001); 5) orthodromic reentrant tachycardia was induced less frequently in the right free wall than in other locations (70% vs. 93%, p less than 0.001); and 6) inducibility of atrial fibrillation was greater in anteroseptal (62%) than in right free wall (21%), left free wall (44%) and posteroseptal (36%) locations (p = 0.01). CONCLUSIONS. The location of the accessory AV pathway is associated with specific electrophysiologic characteristics.
Keywords
Adolescent, Adult, Aged, Arrhythmias, Cardiac/physiopathology, Atrial Fibrillation/physiopathology, Atrioventricular Node/physiopathology, Child, Electrocardiography, Female, Heart Atria/physiopathology, Heart Ventricles/physiopathology, Humans, Male, Middle Aged, Tachycardia/physiopathology, Wolff-Parkinson-White Syndrome/physiopathology
Pubmed
Web of science
Open Access
Yes
Create date
02/10/2009 15:25
Last modification date
20/08/2019 15:26