Risk stratification of sudden cardiac death in subjects with asymptomatic ventricular preexcitation: diagnostic value of non-invasive and invasive methods

Introduction

In subjects with asymptomatic ventricular preexcitation (AVP) guidelines recommend follow-up by non-invasive methods. However, in some patients accessory pathways (APs) show high-risk invasive parameters and risk of sudden death.

Objectives

To assess the association between the non-invasive and invasive risk stratification (NIRS and IRS) in AVP patients in our center.

Material and methods

Retrospective and observational study in 58 patients with AVP, underwent NIRS and IRS. Association between NIRS (electrocardiogram, holter and ergometry testing) and IRS variables (AERP ≤250 msec, SPERRI ≤250 msec, atrioventricular reentrant tachycardia or AF, multiple APs) from the electrophysiological study (EPS), and sensitivity and specificity of NIRS to predict a high-risk EPS were determined.

Results

Of patients with high-risk EPS (n=41), 55% had a previously low-risk NIRS (n=11) while 78% (n=30) had a high-risk NIRS (p=0.05). A low-risk NIRS had a sensitivity (S) 27% and specificity (E) 47% to predict a high-risk EPS.

Conclusions

In our population, 1 of every 2 patients with low-risk NIRS presented a high-risk IRS. The NIRS methods present low S and E for risk stratification in AVP patients.

Funding Acknowledgement

Type of funding sources: None.