La maladie de Parkinson au Canada (serveur d'exploration)

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Risk of Arrhythmia and Sudden Death in Patients With Asymptomatic Preexcitation: A Meta-Analysis

Identifieur interne : 000A58 ( PascalFrancis/Curation ); précédent : 000A57; suivant : 000A59

Risk of Arrhythmia and Sudden Death in Patients With Asymptomatic Preexcitation: A Meta-Analysis

Auteurs : Manoj N. Obeyesekere [Canada] ; Peter Leong-Sit [Canada] ; David Massel [Canada] ; Jaimie Manlucu [Canada] ; Simon Modi [Canada] ; Andrew D. Krahn [Canada] ; Allan C. Skanes [Canada] ; Raymond Yee [Canada] ; Lorne J. Gula [Canada] ; George J. Klein [Canada]

Source :

RBID : Pascal:12-0229220

Descripteurs français

English descriptors

Abstract

Background-The incidence of sudden cardiac death (SCD) and the management of this risk in patients with asymptomatic preexcitation remain controversial. The purpose of this meta-analysis was to define the incidence of SCD and supraventricular tachycardia in patients with asymptomatic Wolff-Parkinson-White ECG pattern. Methods and Results-We performed a systematic search of prospective, retrospective, randomized, or cohort English-language studies in EMBASE and Medline through February 2011. Studies reporting asymptomatic patients with preexcitation who did not undergo ablation were included. Twenty studies involving 1869 patients met our inclusion criteria. Participants were primarily male with a mean age ranging from 7 to 43 years. Ten SCDs were reported involving 11 722 person-years of follow-up. Seven studies originated from Italy and reported 9 SCDs. The risk of SCD is estimated at 1.25 per 1000 person-years (95% confidence interval [CI], 0.57-2.19). A total of 156 supraventricular tachycardias were reported involving 9884 person-years from 18 studies. The risk of supraventricular tachycardia was 16 (95% CI, 10-24) events per 1000 person-years of follow-up. Children had numerically higher SCD (1.93 [95% CI, 0.57-4.1] versus 0.86 [95% CI, 0.28-1.75]; P=0.07) and supraventricular tachycardia (20 [95% CI, 12-31] versus 14 [95% CI, 6-25]; P=0.38) event rates compared with adults. Conclusion-The low incidence of SCD and low risk of supraventricular tachycardia argue against routine invasive management in most asymptomatic patients with the Wolff-Parkinson-White ECG pattern.
pA  
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A08 01  1  ENG  @1 Risk of Arrhythmia and Sudden Death in Patients With Asymptomatic Preexcitation: A Meta-Analysis
A11 01  1    @1 OBEYESEKERE (Manoj N.)
A11 02  1    @1 LEONG-SIT (Peter)
A11 03  1    @1 MASSEL (David)
A11 04  1    @1 MANLUCU (Jaimie)
A11 05  1    @1 MODI (Simon)
A11 06  1    @1 KRAHN (Andrew D.)
A11 07  1    @1 SKANES (Allan C.)
A11 08  1    @1 YEE (Raymond)
A11 09  1    @1 GULA (Lorne J.)
A11 10  1    @1 KLEIN (George J.)
A14 01      @1 University of Western Ontario, Division of Cardiology @2 London, Ontario @3 CAN @Z 1 aut. @Z 2 aut. @Z 3 aut. @Z 4 aut. @Z 5 aut. @Z 6 aut. @Z 7 aut. @Z 8 aut. @Z 9 aut. @Z 10 aut.
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A21       @1 2012
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A44       @0 0000 @1 © 2012 INIST-CNRS. All rights reserved.
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C01 01    ENG  @0 Background-The incidence of sudden cardiac death (SCD) and the management of this risk in patients with asymptomatic preexcitation remain controversial. The purpose of this meta-analysis was to define the incidence of SCD and supraventricular tachycardia in patients with asymptomatic Wolff-Parkinson-White ECG pattern. Methods and Results-We performed a systematic search of prospective, retrospective, randomized, or cohort English-language studies in EMBASE and Medline through February 2011. Studies reporting asymptomatic patients with preexcitation who did not undergo ablation were included. Twenty studies involving 1869 patients met our inclusion criteria. Participants were primarily male with a mean age ranging from 7 to 43 years. Ten SCDs were reported involving 11 722 person-years of follow-up. Seven studies originated from Italy and reported 9 SCDs. The risk of SCD is estimated at 1.25 per 1000 person-years (95% confidence interval [CI], 0.57-2.19). A total of 156 supraventricular tachycardias were reported involving 9884 person-years from 18 studies. The risk of supraventricular tachycardia was 16 (95% CI, 10-24) events per 1000 person-years of follow-up. Children had numerically higher SCD (1.93 [95% CI, 0.57-4.1] versus 0.86 [95% CI, 0.28-1.75]; P=0.07) and supraventricular tachycardia (20 [95% CI, 12-31] versus 14 [95% CI, 6-25]; P=0.38) event rates compared with adults. Conclusion-The low incidence of SCD and low risk of supraventricular tachycardia argue against routine invasive management in most asymptomatic patients with the Wolff-Parkinson-White ECG pattern.
C02 01  X    @0 002B12B03
C02 02  X    @0 002B12A03
C03 01  X  FRE  @0 Trouble du rythme cardiaque @5 01
C03 01  X  ENG  @0 Arrhythmia @5 01
C03 01  X  SPA  @0 Arritmia @5 01
C03 02  X  FRE  @0 Mort subite @5 02
C03 02  X  ENG  @0 Sudden death @5 02
C03 02  X  SPA  @0 Muerte súbita @5 02
C03 03  X  FRE  @0 Arrêt cardiocirculatoire @5 03
C03 03  X  ENG  @0 Cardiocirculatory arrest @5 03
C03 03  X  SPA  @0 Paro cardiocirculatorio @5 03
C03 04  X  FRE  @0 Syndrome de Wolff-Parkinson-White @5 04
C03 04  X  ENG  @0 Wolff-Parkinson-White syndrome @5 04
C03 04  X  SPA  @0 Wolff-Parkinson-White síndrome @5 04
C03 05  X  FRE  @0 Pathologie de l'appareil circulatoire @5 05
C03 05  X  ENG  @0 Cardiovascular disease @5 05
C03 05  X  SPA  @0 Aparato circulatorio patología @5 05
C03 06  X  FRE  @0 Facteur risque @5 09
C03 06  X  ENG  @0 Risk factor @5 09
C03 06  X  SPA  @0 Factor riesgo @5 09
C03 07  X  FRE  @0 Homme @5 10
C03 07  X  ENG  @0 Human @5 10
C03 07  X  SPA  @0 Hombre @5 10
C03 08  X  FRE  @0 Asymptomatique @5 11
C03 08  X  ENG  @0 Asymptomatic @5 11
C03 08  X  SPA  @0 Asintomático @5 11
C03 09  X  FRE  @0 Brutal @5 12
C03 09  X  ENG  @0 Sudden @5 12
C03 09  X  SPA  @0 Súbito @5 12
C03 10  X  FRE  @0 Tachycardie @5 13
C03 10  X  ENG  @0 Tachycardia @5 13
C03 10  X  SPA  @0 Taquicardia @5 13
C03 11  X  FRE  @0 Arrêt cardiorespiratoire @4 INC @5 86
C07 01  X  FRE  @0 Cardiopathie @5 37
C07 01  X  ENG  @0 Heart disease @5 37
C07 01  X  SPA  @0 Cardiopatía @5 37
C07 02  X  FRE  @0 Trouble de la conduction @5 38
C07 02  X  ENG  @0 Conduction disorder @5 38
C07 02  X  SPA  @0 Trastorno conducción @5 38
C07 03  X  FRE  @0 Trouble de l'excitabilité @5 39
C07 03  X  ENG  @0 Excitability disorder @5 39
C07 03  X  SPA  @0 Trastorno excitabilidad @5 39
C07 04  X  FRE  @0 Syndrome de préexcitation ventriculaire @5 40
C07 04  X  ENG  @0 Ventricular preexcitation syndrome @5 40
C07 04  X  SPA  @0 Preexcitación ventricular síndrome @5 40
N21       @1 177
N44 01      @1 OTO
N82       @1 OTO

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Pascal:12-0229220

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<country>Canada</country>
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<author>
<name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name>
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<s1>University of Western Ontario, Division of Cardiology</s1>
<s2>London, Ontario</s2>
<s3>CAN</s3>
<sZ>1 aut.</sZ>
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<country>Canada</country>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">Circulation : (New York, N.Y.)</title>
<title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title>
<idno type="ISSN">0009-7322</idno>
<imprint>
<date when="2012">2012</date>
</imprint>
</series>
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<seriesStmt>
<title level="j" type="main">Circulation : (New York, N.Y.)</title>
<title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title>
<idno type="ISSN">0009-7322</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Arrhythmia</term>
<term>Asymptomatic</term>
<term>Cardiocirculatory arrest</term>
<term>Cardiovascular disease</term>
<term>Human</term>
<term>Risk factor</term>
<term>Sudden</term>
<term>Sudden death</term>
<term>Tachycardia</term>
<term>Wolff-Parkinson-White syndrome</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Trouble du rythme cardiaque</term>
<term>Mort subite</term>
<term>Arrêt cardiocirculatoire</term>
<term>Syndrome de Wolff-Parkinson-White</term>
<term>Pathologie de l'appareil circulatoire</term>
<term>Facteur risque</term>
<term>Homme</term>
<term>Asymptomatique</term>
<term>Brutal</term>
<term>Tachycardie</term>
<term>Arrêt cardiorespiratoire</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Homme</term>
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<div type="abstract" xml:lang="en">Background-The incidence of sudden cardiac death (SCD) and the management of this risk in patients with asymptomatic preexcitation remain controversial. The purpose of this meta-analysis was to define the incidence of SCD and supraventricular tachycardia in patients with asymptomatic Wolff-Parkinson-White ECG pattern. Methods and Results-We performed a systematic search of prospective, retrospective, randomized, or cohort English-language studies in EMBASE and Medline through February 2011. Studies reporting asymptomatic patients with preexcitation who did not undergo ablation were included. Twenty studies involving 1869 patients met our inclusion criteria. Participants were primarily male with a mean age ranging from 7 to 43 years. Ten SCDs were reported involving 11 722 person-years of follow-up. Seven studies originated from Italy and reported 9 SCDs. The risk of SCD is estimated at 1.25 per 1000 person-years (95% confidence interval [CI], 0.57-2.19). A total of 156 supraventricular tachycardias were reported involving 9884 person-years from 18 studies. The risk of supraventricular tachycardia was 16 (95% CI, 10-24) events per 1000 person-years of follow-up. Children had numerically higher SCD (1.93 [95% CI, 0.57-4.1] versus 0.86 [95% CI, 0.28-1.75]; P=0.07) and supraventricular tachycardia (20 [95% CI, 12-31] versus 14 [95% CI, 6-25]; P=0.38) event rates compared with adults. Conclusion-The low incidence of SCD and low risk of supraventricular tachycardia argue against routine invasive management in most asymptomatic patients with the Wolff-Parkinson-White ECG pattern.</div>
</front>
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<s1>LEONG-SIT (Peter)</s1>
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<s1>KRAHN (Andrew D.)</s1>
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<s1>SKANES (Allan C.)</s1>
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<s1>YEE (Raymond)</s1>
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<s1>GULA (Lorne J.)</s1>
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<s1>KLEIN (George J.)</s1>
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<s0>Background-The incidence of sudden cardiac death (SCD) and the management of this risk in patients with asymptomatic preexcitation remain controversial. The purpose of this meta-analysis was to define the incidence of SCD and supraventricular tachycardia in patients with asymptomatic Wolff-Parkinson-White ECG pattern. Methods and Results-We performed a systematic search of prospective, retrospective, randomized, or cohort English-language studies in EMBASE and Medline through February 2011. Studies reporting asymptomatic patients with preexcitation who did not undergo ablation were included. Twenty studies involving 1869 patients met our inclusion criteria. Participants were primarily male with a mean age ranging from 7 to 43 years. Ten SCDs were reported involving 11 722 person-years of follow-up. Seven studies originated from Italy and reported 9 SCDs. The risk of SCD is estimated at 1.25 per 1000 person-years (95% confidence interval [CI], 0.57-2.19). A total of 156 supraventricular tachycardias were reported involving 9884 person-years from 18 studies. The risk of supraventricular tachycardia was 16 (95% CI, 10-24) events per 1000 person-years of follow-up. Children had numerically higher SCD (1.93 [95% CI, 0.57-4.1] versus 0.86 [95% CI, 0.28-1.75]; P=0.07) and supraventricular tachycardia (20 [95% CI, 12-31] versus 14 [95% CI, 6-25]; P=0.38) event rates compared with adults. Conclusion-The low incidence of SCD and low risk of supraventricular tachycardia argue against routine invasive management in most asymptomatic patients with the Wolff-Parkinson-White ECG pattern.</s0>
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<s5>02</s5>
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<fC03 i1="03" i2="X" l="FRE">
<s0>Arrêt cardiocirculatoire</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>Cardiocirculatory arrest</s0>
<s5>03</s5>
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<s0>Paro cardiocirculatorio</s0>
<s5>03</s5>
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<s0>Syndrome de Wolff-Parkinson-White</s0>
<s5>04</s5>
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<s5>04</s5>
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<s5>05</s5>
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<s5>05</s5>
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<s5>05</s5>
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<s5>09</s5>
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<s5>09</s5>
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<s5>10</s5>
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<s5>10</s5>
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<s5>10</s5>
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<s5>11</s5>
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<s5>12</s5>
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<fC03 i1="09" i2="X" l="SPA">
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<s5>12</s5>
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<s5>13</s5>
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<s5>13</s5>
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<s5>86</s5>
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<s5>37</s5>
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<s0>Trouble de la conduction</s0>
<s5>38</s5>
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<s0>Conduction disorder</s0>
<s5>38</s5>
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<s0>Trastorno conducción</s0>
<s5>38</s5>
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<s0>Syndrome de préexcitation ventriculaire</s0>
<s5>40</s5>
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<fC07 i1="04" i2="X" l="ENG">
<s0>Ventricular preexcitation syndrome</s0>
<s5>40</s5>
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<fC07 i1="04" i2="X" l="SPA">
<s0>Preexcitación ventricular síndrome</s0>
<s5>40</s5>
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<fN21>
<s1>177</s1>
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<s1>OTO</s1>
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<s1>OTO</s1>
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