Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome
Identifieur interne : 000035 ( Main/Corpus ); précédent : 000034; suivant : 000036Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome
Auteurs : Béatrice Brembilla-Perrot ; Clément Tatar ; Christine Suty-SeltonSource :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 2010-09.
English descriptors
Abstract
Background: The aim of the study was the evaluation of the predictors of adverse presentation as first arrhythmia in Wolff‐Parkinson‐White syndrome; they usually affect young patients with septal or multiple accessory pathways (AP). Methods: Our population comprised 645 patients with a preexcitation syndrome. Among them, adverse presentation (sudden death, hemodynamically not tolerated atrial fibrillation [AF]) occurred in 60 (9%) (group I). Their clinical and electrophysiological features were compared to group II patients, which consisted of 75 patients with syncope (IIa), 287 with reentrant tachycardia (RT) (IIb), 211 asymptomatic patients (IIc), and 12 with well‐tolerated AF. Results: Sixteen group I patients had triggering factors. Group I patients were older (40 ± 18.5) than group II (34 ± 16) (P = 0.02). Male gender was as frequent in both groups (63%, 59%). Free wall left AP was more frequent in group I (65%) than in group II (37%) (P < 0.001), septal AP less frequent (27% vs 47%) (P = 0.004), multiple APs exceptional. RT was more frequent in group I (57%) than in group IIc (12%) (P < 0.001), less frequent than in group IIb (90.5%) (P < 0.001). AF was more frequent in group I (85%) than in group IIc (22%), or IIb (19%) (P < 0.001). Maximal rate through AP was higher in group I than in group II (P < 0.001). Conclusions: Adverse presentation in WPW may affect patients older than 35 years of both sexes, with a single free wall lateral AP. All could have been identified by an electrophysiological study. (PACE 2010; 33:1074–1081)
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DOI: 10.1111/j.1540-8159.2010.02782.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome</title><author><name sortKey="Brembilla Errot, Beatrice" sort="Brembilla Errot, Beatrice" uniqKey="Brembilla Errot B" first="Béatrice" last="Brembilla-Perrot">Béatrice Brembilla-Perrot</name><affiliation><mods:affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</mods:affiliation></affiliation></author><author><name sortKey="Tatar, Clement" sort="Tatar, Clement" uniqKey="Tatar C" first="Clément" last="Tatar">Clément Tatar</name><affiliation><mods:affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</mods:affiliation></affiliation></author><author><name sortKey="Suty Elton, Christine" sort="Suty Elton, Christine" uniqKey="Suty Elton C" first="Christine" last="Suty-Selton">Christine Suty-Selton</name><affiliation><mods:affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B45F95A9A82CED74BB20BBCA16A1110D142D4338</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1111/j.1540-8159.2010.02782.x</idno><idno type="url">https://api.istex.fr/document/B45F95A9A82CED74BB20BBCA16A1110D142D4338/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000035</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome</title><author><name sortKey="Brembilla Errot, Beatrice" sort="Brembilla Errot, Beatrice" uniqKey="Brembilla Errot B" first="Béatrice" last="Brembilla-Perrot">Béatrice Brembilla-Perrot</name><affiliation><mods:affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</mods:affiliation></affiliation></author><author><name sortKey="Tatar, Clement" sort="Tatar, Clement" uniqKey="Tatar C" first="Clément" last="Tatar">Clément Tatar</name><affiliation><mods:affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</mods:affiliation></affiliation></author><author><name sortKey="Suty Elton, Christine" sort="Suty Elton, Christine" uniqKey="Suty Elton C" first="Christine" last="Suty-Selton">Christine Suty-Selton</name><affiliation><mods:affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Pacing and Clinical Electrophysiology</title><idno type="ISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><imprint><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2010-09">2010-09</date><biblScope unit="volume">33</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1074">1074</biblScope><biblScope unit="page" to="1081">1081</biblScope></imprint><idno type="ISSN">0147-8389</idno></series><idno type="istex">B45F95A9A82CED74BB20BBCA16A1110D142D4338</idno><idno type="DOI">10.1111/j.1540-8159.2010.02782.x</idno><idno type="ArticleID">PACE2782</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0147-8389</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Wolff‐Parkinson‐White syndrome</term><term>electrophysiological study</term><term>malignant arrhythmia</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: The aim of the study was the evaluation of the predictors of adverse presentation as first arrhythmia in Wolff‐Parkinson‐White syndrome; they usually affect young patients with septal or multiple accessory pathways (AP). Methods: Our population comprised 645 patients with a preexcitation syndrome. Among them, adverse presentation (sudden death, hemodynamically not tolerated atrial fibrillation [AF]) occurred in 60 (9%) (group I). Their clinical and electrophysiological features were compared to group II patients, which consisted of 75 patients with syncope (IIa), 287 with reentrant tachycardia (RT) (IIb), 211 asymptomatic patients (IIc), and 12 with well‐tolerated AF. Results: Sixteen group I patients had triggering factors. Group I patients were older (40 ± 18.5) than group II (34 ± 16) (P = 0.02). Male gender was as frequent in both groups (63%, 59%). Free wall left AP was more frequent in group I (65%) than in group II (37%) (P < 0.001), septal AP less frequent (27% vs 47%) (P = 0.004), multiple APs exceptional. RT was more frequent in group I (57%) than in group IIc (12%) (P < 0.001), less frequent than in group IIb (90.5%) (P < 0.001). AF was more frequent in group I (85%) than in group IIc (22%), or IIb (19%) (P < 0.001). Maximal rate through AP was higher in group I than in group II (P < 0.001). Conclusions: Adverse presentation in WPW may affect patients older than 35 years of both sexes, with a single free wall lateral AP. All could have been identified by an electrophysiological study. (PACE 2010; 33:1074–1081)</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>BÉATRICE BREMBILLA‐PERROT M.D.</name><affiliations><json:string>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</json:string></affiliations></json:item><json:item><name>CLÉMENT TATAR M.D.</name><affiliations><json:string>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</json:string></affiliations></json:item><json:item><name>CHRISTINE SUTY‐SELTON M.D.</name><affiliations><json:string>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Wolff‐Parkinson‐White syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>malignant arrhythmia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>electrophysiological study</value></json:item></subject><articleId><json:string>PACE2782</json:string></articleId><language><json:string>eng</json:string></language><abstract>Background: The aim of the study was the evaluation of the predictors of adverse presentation as first arrhythmia in Wolff‐Parkinson‐White syndrome; they usually affect young patients with septal or multiple accessory pathways (AP). Methods: Our population comprised 645 patients with a preexcitation syndrome. Among them, adverse presentation (sudden death, hemodynamically not tolerated atrial fibrillation [AF]) occurred in 60 (9%) (group I). Their clinical and electrophysiological features were compared to group II patients, which consisted of 75 patients with syncope (IIa), 287 with reentrant tachycardia (RT) (IIb), 211 asymptomatic patients (IIc), and 12 with well‐tolerated AF. Results: Sixteen group I patients had triggering factors. Group I patients were older (40 ± 18.5) than group II (34 ± 16) (P = 0.02). Male gender was as frequent in both groups (63%, 59%). Free wall left AP was more frequent in group I (65%) than in group II (37%) (P > 0.001), septal AP less frequent (27% vs 47%) (P = 0.004), multiple APs exceptional. RT was more frequent in group I (57%) than in group IIc (12%) (P > 0.001), less frequent than in group IIb (90.5%) (P > 0.001). AF was more frequent in group I (85%) than in group IIc (22%), or IIb (19%) (P > 0.001). Maximal rate through AP was higher in group I than in group II (P > 0.001). Conclusions: Adverse presentation in WPW may affect patients older than 35 years of both sexes, with a single free wall lateral AP. All could have been identified by an electrophysiological study. (PACE 2010; 33:1074–1081)</abstract><qualityIndicators><score>8.5</score><pdfVersion>1.4</pdfVersion><pdfPageSize>594 x 783 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>1562</abstractCharCount><pdfWordCount>5088</pdfWordCount><pdfCharCount>31673</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>257</abstractWordCount></qualityIndicators><title>Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome</title><genre><json:string>article</json:string></genre><host><volume>33</volume><publisherId><json:string>PACE</json:string></publisherId><pages><total>8</total><last>1081</last><first>1074</first></pages><issn><json:string>0147-8389</json:string></issn><issue>9</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1540-8159</json:string></eissn><title>Pacing and Clinical Electrophysiology</title><doi><json:string>10.1111/(ISSN)1540-8159</json:string></doi></host><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1111/j.1540-8159.2010.02782.x</json:string></doi><id>B45F95A9A82CED74BB20BBCA16A1110D142D4338</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/B45F95A9A82CED74BB20BBCA16A1110D142D4338/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/B45F95A9A82CED74BB20BBCA16A1110D142D4338/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/B45F95A9A82CED74BB20BBCA16A1110D142D4338/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><availability><p>WILEY</p></availability><date>2010</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome</title><author><persName><forename type="first">BÉATRICE</forename><surname>BREMBILLA‐PERROT</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</affiliation></author><author><persName><forename type="first">CLÉMENT</forename><surname>TATAR</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</affiliation></author><author><persName><forename type="first">CHRISTINE</forename><surname>SUTY‐SELTON</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</affiliation></author></analytic><monogr><title level="j">Pacing and Clinical Electrophysiology</title><idno type="pISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><idno type="DOI">10.1111/(ISSN)1540-8159</idno><imprint><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2010-09"></date><biblScope unit="volume">33</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1074">1074</biblScope><biblScope unit="page" to="1081">1081</biblScope></imprint></monogr><idno type="istex">B45F95A9A82CED74BB20BBCA16A1110D142D4338</idno><idno type="DOI">10.1111/j.1540-8159.2010.02782.x</idno><idno type="ArticleID">PACE2782</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background: The aim of the study was the evaluation of the predictors of adverse presentation as first arrhythmia in Wolff‐Parkinson‐White syndrome; they usually affect young patients with septal or multiple accessory pathways (AP). Methods: Our population comprised 645 patients with a preexcitation syndrome. Among them, adverse presentation (sudden death, hemodynamically not tolerated atrial fibrillation [AF]) occurred in 60 (9%) (group I). Their clinical and electrophysiological features were compared to group II patients, which consisted of 75 patients with syncope (IIa), 287 with reentrant tachycardia (RT) (IIb), 211 asymptomatic patients (IIc), and 12 with well‐tolerated AF. Results: Sixteen group I patients had triggering factors. Group I patients were older (40 ± 18.5) than group II (34 ± 16) (P = 0.02). Male gender was as frequent in both groups (63%, 59%). Free wall left AP was more frequent in group I (65%) than in group II (37%) (P < 0.001), septal AP less frequent (27% vs 47%) (P = 0.004), multiple APs exceptional. RT was more frequent in group I (57%) than in group IIc (12%) (P < 0.001), less frequent than in group IIb (90.5%) (P < 0.001). AF was more frequent in group I (85%) than in group IIc (22%), or IIb (19%) (P < 0.001). Maximal rate through AP was higher in group I than in group II (P < 0.001). Conclusions: Adverse presentation in WPW may affect patients older than 35 years of both sexes, with a single free wall lateral AP. All could have been identified by an electrophysiological study. (PACE 2010; 33:1074–1081)</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Wolff‐Parkinson‐White syndrome</term></item><item><term>malignant arrhythmia</term></item><item><term>electrophysiological study</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/B45F95A9A82CED74BB20BBCA16A1110D142D4338/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Inc</publisherName><publisherLoc>Malden, USA</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1540-8159</doi><issn type="print">0147-8389</issn><issn type="electronic">1540-8159</issn><idGroup><id type="product" value="PACE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="PACING CLINICAL ELECTROPHYSIOLOGY">Pacing and Clinical Electrophysiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="09109"><doi origin="wiley">10.1111/pace.2010.33.issue-9</doi><numberingGroup><numbering type="journalVolume" number="33">33</numbering><numbering type="journalIssue" number="9">9</numbering></numberingGroup><coverDate startDate="2010-09">September 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="5" status="forIssue"><doi origin="wiley">10.1111/j.1540-8159.2010.02782.x</doi><idGroup><id type="unit" value="PACE2782"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="tocHeading1"><i>ORIGINAL ARTICLES</i></title></titleGroup><copyright>©2010, The Authors. Journal compilation ©2010 Wiley Periodicals, Inc.</copyright><eventGroup><event type="firstOnline" date="2010-05-11"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-05-11"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.25 mode:FullText source:FullText result:FullText" date="2010-11-05"></event><event type="publishedOnlineFinalForm" date="2010-09-01"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-06"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-03"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="1074">1074</numbering><numbering type="pageLast" number="1081">1081</numbering></numberingGroup><correspondenceTo>Address for reprints: B. Brembilla‐Perrot, M.D., Cardiologie – University Hospital of Brabois – 54500 Vandoeuvre Les Nancy, France. Fax: 00 333 83 15 42 26; e‐mail: <email normalForm="b.brembilla-perrot@chu-nancy.fr">b.brembilla‐perrot@chu‐nancy.fr</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:PACE.PACE2782.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received October 20, 2009; revised December 23, 2009; accepted March 10, 2010.</unparsedEditorialHistory><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="5"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="40"></count><count type="linksCrossRef" number="48"></count></countGroup><titleGroup><title type="main">Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome</title><title type="shortAuthors">BREMBILLA‐PERROT, ET AL.</title><title type="short">MALIGNANT WOLFF‐PARKINSON‐WHITE SYNDROME</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>BÉATRICE</givenNames><familyName>BREMBILLA‐PERROT</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>CLÉMENT</givenNames><familyName>TATAR</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>CHRISTINE</givenNames><familyName>SUTY‐SELTON</familyName><degrees>M.D.</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="FR"><unparsedAffiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1"><i>Wolff‐Parkinson‐White syndrome</i></keyword><keyword xml:id="k2"><i>malignant arrhythmia</i></keyword><keyword xml:id="k3"><i>electrophysiological study</i></keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p> <b><i>Background:</i></b> <i>The aim of the study was the evaluation of the predictors of adverse presentation as first arrhythmia in Wolff‐Parkinson‐White syndrome; they usually affect young patients with septal or multiple accessory pathways (AP).</i></p><p> <b><i>Methods:</i></b> <i>Our population comprised 645 patients with a preexcitation syndrome. Among them, adverse presentation (sudden death, hemodynamically not tolerated atrial fibrillation [AF]) occurred in 60 (9%) (group I). Their clinical and electrophysiological features were compared to group II patients, which consisted of 75 patients with syncope (IIa), 287 with reentrant tachycardia (RT) (IIb), 211 asymptomatic patients (IIc), and 12 with well‐tolerated AF.</i></p><p> <b><i>Results:</i></b> <i>Sixteen group I patients had triggering factors. Group I patients were older (40 ± 18.5) than group II (34 ± 16) (P = 0.02). Male gender was as frequent in both groups (63%, 59%). Free wall left AP was more frequent in group I (65%) than in group II (37%) (P < 0.001), septal AP less frequent (27% vs 47%) (P = 0.004), multiple APs exceptional. RT was more frequent in group I (57%) than in group IIc (12%) (P < 0.001), less frequent than in group IIb (90.5%) (P < 0.001). AF was more frequent in group I (85%) than in group IIc (22%), or IIb (19%) (P < 0.001). Maximal rate through AP was higher in group I than in group II (P < 0.001).</i></p><p> <b><i>Conclusions:</i></b> <i>Adverse presentation in WPW may affect patients older than 35 years of both sexes, with a single free wall lateral AP. All could have been identified by an electrophysiological study. (PACE 2010; 33:1074–1081)</i></p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome</title></titleInfo><titleInfo type="abbreviated"><title>MALIGNANT WOLFF‐PARKINSON‐WHITE SYNDROME</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Risk Factors of Adverse Presentation as the First Arrhythmia in Wolff‐Parkinson‐White Syndrome</title></titleInfo><name type="personal"><namePart type="given">BÉATRICE</namePart><namePart type="family">BREMBILLA‐PERROT</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">CLÉMENT</namePart><namePart type="family">TATAR</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">CHRISTINE</namePart><namePart type="family">SUTY‐SELTON</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, University Hospital of Brabois, Vandoeuvre, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Inc</publisher><place><placeTerm type="text">Malden, USA</placeTerm></place><dateIssued encoding="w3cdtf">2010-09</dateIssued><edition>Received October 20, 2009; revised December 23, 2009; accepted March 10, 2010.</edition><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">5</extent><extent unit="references">40</extent></physicalDescription><abstract lang="en">Background: The aim of the study was the evaluation of the predictors of adverse presentation as first arrhythmia in Wolff‐Parkinson‐White syndrome; they usually affect young patients with septal or multiple accessory pathways (AP). Methods: Our population comprised 645 patients with a preexcitation syndrome. Among them, adverse presentation (sudden death, hemodynamically not tolerated atrial fibrillation [AF]) occurred in 60 (9%) (group I). Their clinical and electrophysiological features were compared to group II patients, which consisted of 75 patients with syncope (IIa), 287 with reentrant tachycardia (RT) (IIb), 211 asymptomatic patients (IIc), and 12 with well‐tolerated AF. Results: Sixteen group I patients had triggering factors. Group I patients were older (40 ± 18.5) than group II (34 ± 16) (P = 0.02). Male gender was as frequent in both groups (63%, 59%). Free wall left AP was more frequent in group I (65%) than in group II (37%) (P < 0.001), septal AP less frequent (27% vs 47%) (P = 0.004), multiple APs exceptional. RT was more frequent in group I (57%) than in group IIc (12%) (P < 0.001), less frequent than in group IIb (90.5%) (P < 0.001). AF was more frequent in group I (85%) than in group IIc (22%), or IIb (19%) (P < 0.001). Maximal rate through AP was higher in group I than in group II (P < 0.001). Conclusions: Adverse presentation in WPW may affect patients older than 35 years of both sexes, with a single free wall lateral AP. All could have been identified by an electrophysiological study. (PACE 2010; 33:1074–1081)</abstract><subject lang="en"><genre>Keywords</genre><topic>Wolff‐Parkinson‐White syndrome</topic><topic>malignant arrhythmia</topic><topic>electrophysiological study</topic></subject><relatedItem type="host"><titleInfo><title>Pacing and Clinical Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0147-8389</identifier><identifier type="eISSN">1540-8159</identifier><identifier type="DOI">10.1111/(ISSN)1540-8159</identifier><identifier type="PublisherID">PACE</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>33</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>1074</start><end>1081</end><total>8</total></extent></part></relatedItem><identifier type="istex">B45F95A9A82CED74BB20BBCA16A1110D142D4338</identifier><identifier type="DOI">10.1111/j.1540-8159.2010.02782.x</identifier><identifier type="ArticleID">PACE2782</identifier><accessCondition type="use and reproduction" contentType="copyright">©2010, The Authors. 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