Initiation of atrial fibrillation in the Wolff-Parkinson-White syndrome: The importance of the accessory pathway
Identifieur interne : 004398 ( Main/Exploration ); précédent : 004397; suivant : 004399Initiation of atrial fibrillation in the Wolff-Parkinson-White syndrome: The importance of the accessory pathway
Auteurs : Mark Wathen [Canada] ; Andrea Natale [Canada] ; Kevin Wolfe [Canada] ; Raymond Yee [Canada] ; George Klein [Canada]Source :
- American Heart Journal [ 0002-8703 ] ; 1993.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Accessory bundle, Adult, Atrial Fibrillation (etiology), Atrial Fibrillation (prevention & control), Atrial fibrillation, Atrioventricular Node (surgery), Cardiac Pacing, Artificial, Catheter Ablation, Electrocardiography, Electrophysiology, Female, Human, Humans, Initiation, Male, Pathophysiology, Wolff Parkinson White syndrome, Wolff-Parkinson-White Syndrome (complications), Wolff-Parkinson-White Syndrome (physiopathology), Wolff-Parkinson-White Syndrome (surgery).
- MESH :
- complications : Wolff-Parkinson-White Syndrome.
- etiology : Atrial Fibrillation.
- physiopathology : Wolff-Parkinson-White Syndrome.
- prevention & control : Atrial Fibrillation.
- surgery : Atrioventricular Node, Wolff-Parkinson-White Syndrome.
- Adult, Cardiac Pacing, Artificial, Catheter Ablation, Electrocardiography, Female, Humans, Male.
Abstract
Atrial fibrillation in the Wolff-Parkinson-White syndrome may be related to microreentry in the accessory pathway. If such is the case, catheter ablation of the accessory pathway should eliminate atrial fibrillation. Among 95 patients undergoing catheter ablation, 20 had atrial fibrillation during standard electrophysiologic study (atrial vulnerability) before ablation. There were 16 women and four men with a mean age of 32 years. Before ablation six patients required electrical cardioversion. Thirty minutes after ablation, 11 continued to have inducible atrial fibrillation. Atrial fibrillation terminated spontaneously in every patient after ablation. A control group of 20 patients with accessory pathway ablation had no inducible atrial fibrillation before or after ablation. Catheter ablation had no effect on atrial properties including functional refractory period (227 ± 37 vs 215 ± 29 msec before versus after ablation, mean ± SD) or wavelength (7.4 ± 3.2 vs 7.2 ± 2.7 before versus after ablation). These data suggest that an intact accessory pathway is not necessary for initiation of atrial fibrillation in most patients with Wolff-Parkinson-White syndrome. A rapid ventricular response over the accessory pathway may facilitate the perpetuation of atrial fibrillation in persons prone to this arrhythmia.
Url:
DOI: 10.1016/0002-8703(93)90167-8
Affiliations:
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Le document en format XML
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xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">American Heart Journal</title><title level="j" type="abbrev">YMHJ</title><idno type="ISSN">0002-8703</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1993">1993</date><biblScope unit="volume">125</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="753">753</biblScope><biblScope unit="page" to="759">759</biblScope></imprint><idno type="ISSN">0002-8703</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-8703</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accessory bundle</term><term>Adult</term><term>Atrial Fibrillation (etiology)</term><term>Atrial Fibrillation (prevention & control)</term><term>Atrial fibrillation</term><term>Atrioventricular Node (surgery)</term><term>Cardiac Pacing, Artificial</term><term>Catheter Ablation</term><term>Electrocardiography</term><term>Electrophysiology</term><term>Female</term><term>Human</term><term>Humans</term><term>Initiation</term><term>Male</term><term>Pathophysiology</term><term>Wolff Parkinson White syndrome</term><term>Wolff-Parkinson-White Syndrome (complications)</term><term>Wolff-Parkinson-White Syndrome (physiopathology)</term><term>Wolff-Parkinson-White Syndrome (surgery)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Atrial Fibrillation</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Atrial Fibrillation</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Atrioventricular Node</term><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cardiac Pacing, Artificial</term><term>Catheter Ablation</term><term>Electrocardiography</term><term>Female</term><term>Humans</term><term>Male</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Electrophysiologie</term><term>Faisceau accessoire</term><term>Fibrillation auriculaire</term><term>Homme</term><term>Initiation</term><term>Physiopathologie</term><term>Wolff Parkinson White syndrome</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Atrial fibrillation in the Wolff-Parkinson-White syndrome may be related to microreentry in the accessory pathway. If such is the case, catheter ablation of the accessory pathway should eliminate atrial fibrillation. Among 95 patients undergoing catheter ablation, 20 had atrial fibrillation during standard electrophysiologic study (atrial vulnerability) before ablation. There were 16 women and four men with a mean age of 32 years. Before ablation six patients required electrical cardioversion. Thirty minutes after ablation, 11 continued to have inducible atrial fibrillation. Atrial fibrillation terminated spontaneously in every patient after ablation. A control group of 20 patients with accessory pathway ablation had no inducible atrial fibrillation before or after ablation. Catheter ablation had no effect on atrial properties including functional refractory period (227 ± 37 vs 215 ± 29 msec before versus after ablation, mean ± SD) or wavelength (7.4 ± 3.2 vs 7.2 ± 2.7 before versus after ablation). These data suggest that an intact accessory pathway is not necessary for initiation of atrial fibrillation in most patients with Wolff-Parkinson-White syndrome. A rapid ventricular response over the accessory pathway may facilitate the perpetuation of atrial fibrillation in persons prone to this arrhythmia.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Wathen, Mark" sort="Wathen, Mark" uniqKey="Wathen M" first="Mark" last="Wathen">Mark Wathen</name></noRegion><name sortKey="Klein, George" sort="Klein, George" uniqKey="Klein G" first="George" last="Klein">George Klein</name><name sortKey="Natale, Andrea" sort="Natale, Andrea" uniqKey="Natale A" first="Andrea" last="Natale">Andrea Natale</name><name sortKey="Wolfe, Kevin" sort="Wolfe, Kevin" uniqKey="Wolfe K" first="Kevin" last="Wolfe">Kevin Wolfe</name><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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