Document Detail

Mechanisms for atrial fibrillation in patients with Wolff-Parkinson-White syndrome.
MedLine Citation:
PMID:  11942586     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Paroxysmal atrial fibrillation (PAF) frequently occurs in patients with Wolff-Parkinson-White (WPW) syndrome. To elucidate the mechanisms for PAF, we performed electrophysiologic studies (EPS) before and after ablation of accessory pathways (APs). METHODS AND RESULTS: We investigated 24 patients with WPW syndrome who had AV reciprocating tachycardia and prior PAF and had undergone successful ablation of APs. Patients in whom atrial fibrillation (AF) was induced by EPS at day 7 after ablation were considered the inducible AF group (n = 14), and patients in whom AF was not induced by EPS at day 7 after ablation were considered the noninducible AF group (n = 10). Fifteen patients with AV nodal reentrant tachycardia (AVNRT) but without PAF who underwent ablation of the slow AV nodal pathways served as the control group (AVNRT group). Maximal atrial conduction delay and conduction delay zone, which are indices of atrial vulnerability, were measured before and after ablation. Before ablation, maximal atrial conduction delay and conduction delay zone were significantly greater (P < 0.0001 and P < 0.0001, respectively) in the two WPW syndrome groups than in the AVNRT group, indicating increased atrial vulnerability in WPW syndrome with PAF. After ablation, these parameters did not change in the inducible AF group, whereas they were significantly (P < 0.0001) decreased in the noninducible AF group and were not different from those in the AVNRT group, indicating normalized atrial vulnerability in the noninducible AF group after ablation. The prospective study demonstrated that PAF recurred only in the inducible AF group during long-term follow-up (17+/-7 months). CONCLUSION: The findings of this study suggest that there are two mechanisms of PAF in patients with WPW syndrome: one mechanism is reversible and AP-dependent atrial vulnerability, and the other is intrinsic and AP-independent atrial vulnerability.
Takashi Hamada; Tatsuro Hiraki; Hisao Ikeda; Ichiro Kubara; Teruhisa Yoshida; Masanobu Ohga; Tsutomu Imaizumi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  13     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-04-10     Completed Date:  2002-09-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  223-9     Citation Subset:  IM    
Department of Internal Medicine III and the Cardiovascular Research Institute, Kurume University School of Medicine, Japan.
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MeSH Terms
Atrial Fibrillation / etiology,  physiopathology*
Catheter Ablation
Chi-Square Distribution
Follow-Up Studies
Heart Atria / physiopathology
Middle Aged
Wolff-Parkinson-White Syndrome / complications,  physiopathology*,  surgery
Comment In:
J Cardiovasc Electrophysiol. 2002 Mar;13(3):230   [PMID:  11942587 ]

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

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