Document Detail


Asymptomatic ventricular preexcitation: a long-term prospective follow-up study of 293 adult patients.
MedLine Citation:
PMID:  19808453     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sudden cardiac death can be the first clinical presentation of asymptomatic ventricular preexcitation. METHODS AND RESULTS: From 1995 to 2005, we prospectively collected clinical and electrophysiological data among 293 adults with asymptomatic ventricular preexcitation (61.4% males; median age, 36 years; interquartile range [IQR], 28 to 47.5). After electrophysiological testing, patients were prospectively followed, taking no drugs. The primary end point of the study was the occurrence of a first arrhythmic event. Predictors of arrhythmic events were analyzed by univariate and multivariate Cox models. Over a median follow-up of 67 months (minimum to maximum, 8 to 90), after electrophysiological testing, 262 patients (median age, 37 years; IQR, 30 to 48) did not experience arrhythmic events, remaining totally asymptomatic, whereas 31 patients (median age, 25 years; IQR, 22 to 29; median follow-up, 27 months; minimum to maximum, 8 to 55) had a first arrhythmic event, which was potentially life-threatening in 17 of them (median age, 24 years; IQR, 20 to 28.5; median follow-up, 25 months; minimum to maximum, 9 to 55). Potentially life-threatening tachyarrhythmias resulted in resuscitated cardiac arrest (1 patient), presyncope (7 patients) syncope (4 patients), or dizziness (5 patients). In multivariate analysis age (P=0.004), inducibility (P=0.001) and anterograde effective refractory period of the accessory pathway < or = 250 ms (P=0.001) predicted potentially life-threatening arrhythmias. CONCLUSIONS: These results indicate that prognosis of adults who present with asymptomatic ventricular preexcitation is good, and the risk of a significant event is small. Short anterograde effective refractory period of the accessory pathway and inducibility at baseline are independent predictors of potentially life-threatening arrhythmic events, and the risk decreases with increasing age.
Authors:
Vincenzo Santinelli; Andrea Radinovic; Francesco Manguso; Gabriele Vicedomini; Giuseppe Ciconte; Simone Gulletta; Gabriele Paglino; Stefania Sacchi; Simone Sala; Cristiano Ciaccio; Carlo Pappone
Related Documents :
6695813 - Extracardiac adverse effects of flecainide.
8674173 - Comparison of d,l-sotalol and implantable defibrillators for treatment of sustained ven...
11528093 - Retinal abnormalities in newly diagnosed adult acute myeloid leukemia.
Publication Detail:
Type:  Journal Article     Date:  2009-02-13
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  2     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-10-07     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-7     Citation Subset:  IM    
Affiliation:
Department of Arrhythmology, Electrophysiology, and Cardiac Pacing Unit, San Raffaele Scientific Institute, 20132 Milan, Italy. vincenzo.santinelli@hsr.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Catheter Ablation*
Death, Sudden, Cardiac / epidemiology*,  prevention & control*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Refractory Period, Electrophysiological / physiology
Risk Factors
Wolff-Parkinson-White Syndrome / mortality*,  physiopathology*,  surgery
Young Adult
Comments/Corrections
Comment In:
Circ Arrhythm Electrophysiol. 2009 Apr;2(2):97-9   [PMID:  19808451 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Canine model of esophageal injury and atrial-esophageal fistula after applications of forward-firing...
Next Document:  Esophageal capsule endoscopy after radiofrequency catheter ablation for atrial fibrillation: documen...