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Risk of Malignant Arrhythmias in Initially Symptomatic Patients with WPW Syndrome: Results of a Prospective Long-Term Electrophysiological Follow-Up Study.
MedLine Citation:
PMID:  22215859     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The available amount of detailed long-term data in patients with WPW syndrome is limited and no prospective electrophysiological studies looking at predictors of MA are available. METHODS AND RESULTS: Among 8575 symptomatic WPW patients with atrioventricular reentrant tachycardia (AVRT) referred for EPT, 369 (mean age, 23±12.5 years) declined catheter ablation and were followed. Primary endpoint of the study was to evaluate over a 5-year follow-up predictors and characteristics of patients developing MA. After a mean follow-up of 42.1±10 months, MA developed in 29 patients (mean age, 13.9±5.6  years, 26 M) resulting in presyncope/syncope (25 patients), hemodynamic collapse (3 patients) or cardiac arrest due to ventricular fibrillation (1 patient). Of the remaining 340 patients, 168 (mean age, 34.2±9.0 years) remained asymptomatic up to 5 years and 172 (mean age, 13.6±5.1) had benign recurrence including sustained AVRT (132 patients) or AF (40 patients). As compared with no-MA group, MA group showed shorter AP-AERP (p<0.001), more often exhibited multiple AP (p<0.001) and AVRT triggering sustained preexcited AF (AVRT-AF) was more frequently inducible (p<0.001). Multivariable analysis demonstrated that short AP-AERP (p<0.001) and AVRT-AF (p<0.001) were independent predictors of MA. CONCLUSIONS: Symptomatic patients with WPW syndrome generally have a good outcome and predictors of malignant arrhythmias are similar to those reported for asymptomatic patients with ventricular preexcitation.
Authors:
Carlo Pappone; Gabriele Vicedomini; Francesco Manguso; Mario Baldi; Alessia Pappone; Andrea Petretta; Raffaele Vitale; Massimo Saviano; Cristiano Ciaccio; Luigi Giannelli; Zarko Calovic; Luigi Tavazzi; Vincenzo Santinelli
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-3
Journal Detail:
Title:  Circulation     Volume:  -     ISSN:  1524-4539     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Maria Cecilia Hospital, Cotignola, Italy.
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