Velázquez-Rodríguez E, Pacheco-Bouthillier A, Rodríguez-Piña H, Deras-Mejía LM. [The electrophysiology of Wolff-Parkinson-White in the asymptomatic patient with activity or with high professional risk].
ARCHIVOS DE CARDIOLOGIA DE MEXICO 2012;
82:282-9. [PMID:
23164744 DOI:
10.1016/j.acmx.2012.09.003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 09/18/2012] [Accepted: 09/19/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE
Describe the electrophysiological characteristics in subjects with asymptomatic Wolff-Parkinson-White with sports activities or high professional responsibility.
METHODS
Nineteen subjects, mean age 33 ± 13 years (group A). The electrophysiological characteristics were compared with a matched group with symptomatic WPW (group B).
RESULTS
At baseline the anterograde refractory period and the anterograde conduction 1:1 over the accessory pathway were longer in group A (300 ± 48 ms vs 262 ± 32 ms, p < 0.05 and 355 ± 108 ms vs 307 ± 86 ms, p < 0.05), respectively. None of group A had a anterograde refractory period< 250 ms and 58% showed absence of retrograde conduction over the accessory pathway vs 4% of group B (p < 0.001). Induction of tachycardia was significantly less in group A (5%) than in group B (92%) (p < 0.001). Atrial fibrillation was induced in only one of group A vs 32% of group B (p < 0.001).
CONCLUSION
We confirm the benign electrophysiological characteristics in asymptomatic compared to symptomatic subjects. Poor anterograde conduction along with absence of retrograde conduction explains the low frequency of tachyarrhythmias and would not support the routine investigation of all asymptomatic subjects. But, due to possible consequences, remains the systematic indication for preventive ablation in the subgroup of asymptomatic subjects with sporting activities or high professional responsibility.
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