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Clinical, electrocardiographic, and electrophysiologic characteristics of patients with a fasciculoventricular pathway: The role of PRKAG2 mutation.
MedLine Citation:
PMID:  20888928     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: The ECG, clinical, and electrophysiologic profiles of patients with a fasciculoventricular pathway are well described. Fasciculoventricular pathways occurring in the setting of glycogen storage cardiomyopathy possess unique features.
OBJECTIVE: The purpose of this study was to compare the clinical, ECG, and electrophysiologic characteristics of patients with a fasciculoventricular pathway, with or without glycogen storage cardiomyopathy.
METHODS: Two groups of patients with a fasciculoventricular pathway were compared: group A consisted of 10 patients with the PRKAG2 mutation (Arg302gln), and group B consisted of 9 patients without the mutation.
RESULTS: Thirty percent of group A patients had left ventricular hypertrophy, and none had an additional accessory pathway. Group B patients had no structural heart disease, and 33% had an additional accessory pathway. Group A patients had a slower resting heart rate (56 ± 7 vs 75 ± 10 bpm, P <0.0001), a wider QRS complex (0.15 ± 0.01 vs 0.11 ± 0.02 ms, P = .0004), and a longer HV interval (34 ± 1 vs 25 ± 3 ms, P = .0003). During long-term follow-up, 50% of group A patients developed complete AV block versus none in group B. Eighty percent of group A patients developed atrial flutter and/or atrial fibrillation. No Group B patient had any arrhythmia during follow-up after successful ablation of additional arrhythmia circuits. No sustained ventricular arrhythmia was induced in any patient from either group.
CONCLUSION: Patients with a fasciculoventricular pathway associated with the PRKAG2 mutation have distinct clinical, ECG, and electrophysiologic profiles and should be correctly identified because of their ominous long-term prognosis. Patients without the mutation have an excellent arrhythmia-free prognosis after treatment of additional circuits.
Authors:
Eduardo Back Sternick; Antonio Oliva; Luiz Márcio Gerken; Luiz Magalhães; Ricardo Scarpelli; Frederico Soares Correia; Silvia Rego; Oto Santana; Ramon Brugada; Hein J J Wellens
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Publication Detail:
Type:  Journal Article     Date:  2010-10-01
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  8     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  58-64     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Arrhythmia Unit, Biocor Instituto, Nova Lima, Brazil. eduardosternick@terra.com.br
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