Syncope in the Wolff‐Parkinson‐White Syndrome: Incidence and Electrophysiologic Correlates
Identifieur interne : 000042 ( Main/Corpus ); précédent : 000041; suivant : 000043Syncope in the Wolff‐Parkinson‐White Syndrome: Incidence and Electrophysiologic Correlates
Auteurs : Raymond Yee ; George J. KleinSource :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 1984-05.
English descriptors
Abstract
Syncope in the patient with Wolff‐Parkinson‐White (WPW) syndrome raises the specter of rapid tachyarrhythmias and the possibility of sudden cardiac death. We reviewed the records of 55 consecutive WPW patients referred for electrophysiologic evaluation of known or suspected arrhythmias to determine the incidence and significance of syncope. Twelve patients (22.6%) reported the occurrence of at least one episode of syncope. In eleven (20%) of these, syncope was preceded by rapid palpitations. Forty‐three patients (77.4%) had no syncopal episodes. These two groups did not differ significantly with regard to age, sex, presence of associated cardiac or neurologic disease, drug history or accessory pathway location. There was no significant difference in cycle length of reciprocating tachycardia (syncope = 295.6 ± 59.8 vs non‐syncope = 334.5 ± 59.6 ms, p < .5), shortest R‐R intervals between preexcited beats (260 ± 78.6 vs 246.7 ± 55.4 ms, p < .5) and average R‐R interval (364.4 ± 37.9 vs 367.4 ± 77.5 ms, p < .5) measured during atrial fibrillation. The anterograde effective refractory period of the accessory pathway (292.1 ± 31.9 vs 299 ± 58.1 ms, p < .5) and the shortest cycle length with 1:1 conduction over the accessory pathway (306.7 ± 75 vs 289.1 ± 77.5 ms, p < .5) similarly did not differ. We conclude that syncope occurs in approximately 20% of patients with the Wolff‐Parkinson‐White syndrome referred for assessment of tachycardia. Patients with syncope do not have distinct clinical features or a more malignant electrophysiologic profile, suggesting that other extracardiac factors may play an important roe in the genesis of syncope in this group.
Url:
DOI: 10.1111/j.1540-8159.1984.tb04922.x
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We reviewed the records of 55 consecutive WPW patients referred for electrophysiologic evaluation of known or suspected arrhythmias to determine the incidence and significance of syncope. Twelve patients (22.6%) reported the occurrence of at least one episode of syncope. In eleven (20%) of these, syncope was preceded by rapid palpitations. Forty‐three patients (77.4%) had no syncopal episodes. These two groups did not differ significantly with regard to age, sex, presence of associated cardiac or neurologic disease, drug history or accessory pathway location. There was no significant difference in cycle length of reciprocating tachycardia (syncope = 295.6 ± 59.8 vs non‐syncope = 334.5 ± 59.6 ms, p < .5), shortest R‐R intervals between preexcited beats (260 ± 78.6 vs 246.7 ± 55.4 ms, p < .5) and average R‐R interval (364.4 ± 37.9 vs 367.4 ± 77.5 ms, p < .5) measured during atrial fibrillation. The anterograde effective refractory period of the accessory pathway (292.1 ± 31.9 vs 299 ± 58.1 ms, p < .5) and the shortest cycle length with 1:1 conduction over the accessory pathway (306.7 ± 75 vs 289.1 ± 77.5 ms, p < .5) similarly did not differ. We conclude that syncope occurs in approximately 20% of patients with the Wolff‐Parkinson‐White syndrome referred for assessment of tachycardia. Patients with syncope do not have distinct clinical features or a more malignant electrophysiologic profile, suggesting that other extracardiac factors may play an important roe in the genesis of syncope in this group.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>RAYMOND YEE</name><affiliations><json:string>Clinical Electrophysiology Laboratory, University Hospital, London, Ontario</json:string></affiliations></json:item><json:item><name>GEORGE J. KLEIN</name><affiliations><json:string>Clinical Electrophysiology Laboratory, University Hospital, London, Ontario</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>syncope</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sudden death</value></json:item></subject><articleId><json:string>PACE381</json:string></articleId><language><json:string>eng</json:string></language><abstract>Syncope in the patient with Wolff‐Parkinson‐White (WPW) syndrome raises the specter of rapid tachyarrhythmias and the possibility of sudden cardiac death. We reviewed the records of 55 consecutive WPW patients referred for electrophysiologic evaluation of known or suspected arrhythmias to determine the incidence and significance of syncope. Twelve patients (22.6%) reported the occurrence of at least one episode of syncope. In eleven (20%) of these, syncope was preceded by rapid palpitations. Forty‐three patients (77.4%) had no syncopal episodes. These two groups did not differ significantly with regard to age, sex, presence of associated cardiac or neurologic disease, drug history or accessory pathway location. There was no significant difference in cycle length of reciprocating tachycardia (syncope = 295.6 ± 59.8 vs non‐syncope = 334.5 ± 59.6 ms, p > .5), shortest R‐R intervals between preexcited beats (260 ± 78.6 vs 246.7 ± 55.4 ms, p > .5) and average R‐R interval (364.4 ± 37.9 vs 367.4 ± 77.5 ms, p > .5) measured during atrial fibrillation. The anterograde effective refractory period of the accessory pathway (292.1 ± 31.9 vs 299 ± 58.1 ms, p > .5) and the shortest cycle length with 1:1 conduction over the accessory pathway (306.7 ± 75 vs 289.1 ± 77.5 ms, p > .5) similarly did not differ. We conclude that syncope occurs in approximately 20% of patients with the Wolff‐Parkinson‐White syndrome referred for assessment of tachycardia. 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Klein, M.D., Cardiac Investigation Unit, University Hospital, P.O. Box 5339, Station ‘A’ London, Ontario, Canada N6A 5A5.</p></note><affiliation>Clinical Electrophysiology Laboratory, University Hospital, London, Ontario</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 Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1984-05"></date><biblScope unit="volume">7</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="381">381</biblScope><biblScope unit="page" to="388">388</biblScope></imprint></monogr><idno type="istex">EC97DF627F62A96D03B4F2C6B33B0C8E7D22EFD3</idno><idno type="DOI">10.1111/j.1540-8159.1984.tb04922.x</idno><idno type="ArticleID">PACE381</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1984</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Syncope in the patient with Wolff‐Parkinson‐White (WPW) syndrome raises the specter of rapid tachyarrhythmias and the possibility of sudden cardiac death. We reviewed the records of 55 consecutive WPW patients referred for electrophysiologic evaluation of known or suspected arrhythmias to determine the incidence and significance of syncope. Twelve patients (22.6%) reported the occurrence of at least one episode of syncope. In eleven (20%) of these, syncope was preceded by rapid palpitations. Forty‐three patients (77.4%) had no syncopal episodes. These two groups did not differ significantly with regard to age, sex, presence of associated cardiac or neurologic disease, drug history or accessory pathway location. There was no significant difference in cycle length of reciprocating tachycardia (syncope = 295.6 ± 59.8 vs non‐syncope = 334.5 ± 59.6 ms, p < .5), shortest R‐R intervals between preexcited beats (260 ± 78.6 vs 246.7 ± 55.4 ms, p < .5) and average R‐R interval (364.4 ± 37.9 vs 367.4 ± 77.5 ms, p < .5) measured during atrial fibrillation. The anterograde effective refractory period of the accessory pathway (292.1 ± 31.9 vs 299 ± 58.1 ms, p < .5) and the shortest cycle length with 1:1 conduction over the accessory pathway (306.7 ± 75 vs 289.1 ± 77.5 ms, p < .5) similarly did not differ. We conclude that syncope occurs in approximately 20% of patients with the Wolff‐Parkinson‐White syndrome referred for assessment of tachycardia. Patients with syncope do not have distinct clinical features or a more malignant electrophysiologic profile, suggesting that other extracardiac factors may play an important roe in the genesis of syncope in this group.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Wolff‐Parkinson‐White syndrome</term></item><item><term>syncope</term></item><item><term>sudden death</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1984-05">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/EC97DF627F62A96D03B4F2C6B33B0C8E7D22EFD3/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 Ltd</publisherName><publisherLoc>Oxford, UK</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="05003"><doi origin="wiley">10.1111/pace.1984.7.issue-3</doi><numberingGroup><numbering type="journalVolume" number="7">7</numbering><numbering type="journalIssue" number="3">3</numbering></numberingGroup><coverDate startDate="1984-05">May 1984</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="0038100" status="forIssue"><doi origin="wiley">10.1111/j.1540-8159.1984.tb04922.x</doi><idGroup><id type="unit" value="PACE381"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title></titleGroup><eventGroup><event type="firstOnline" date="2006-06-30"></event><event type="publishedOnlineFinalForm" date="2006-06-30"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:HeaderRef result:HeaderRef" date="2010-03-02"></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="381">381</numbering><numbering type="pageLast" number="388">388</numbering></numberingGroup><correspondenceTo>Address for reprints: George J. Klein, M.D., Cardiac Investigation Unit, University Hospital, P.O. Box 5339, Station ‘A’ London, Ontario, Canada N6A 5A5.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:PACE.PACE381.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received November 18, 1983; accepted January 6, 1984.</unparsedEditorialHistory><countGroup><count type="referenceTotal" number="19"></count><count type="linksCrossRef" number="4"></count></countGroup><titleGroup><title type="main">Syncope in the Wolff‐Parkinson‐White Syndrome: Incidence and Electrophysiologic Correlates</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>RAYMOND</givenNames><familyName>YEE</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1" noteRef="#fn1" corresponding="yes"><personName><givenNames>GEORGE J.</givenNames><familyName>KLEIN</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Clinical Electrophysiology Laboratory, University Hospital, London, Ontario</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">Wolff‐Parkinson‐White syndrome</keyword><keyword xml:id="k2">syncope</keyword><keyword xml:id="k3">sudden death</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Syncope in the patient with Wolff‐Parkinson‐White (WPW) syndrome raises the specter of rapid tachyarrhythmias and the possibility of sudden cardiac death. We reviewed the records of 55 consecutive WPW patients referred for electrophysiologic evaluation of known or suspected arrhythmias to determine the incidence and significance of syncope. Twelve patients (22.6%) reported the occurrence of at least one episode of syncope. In eleven (20%) of these, syncope was preceded by rapid palpitations. Forty‐three patients (77.4%) had no syncopal episodes. These two groups did not differ significantly with regard to age, sex, presence of associated cardiac or neurologic disease, drug history or accessory pathway location. There was no significant difference in cycle length of reciprocating tachycardia (syncope = 295.6 ± 59.8 vs non‐syncope = 334.5 ± 59.6 ms, p < .5), shortest R‐R intervals between preexcited beats (260 ± 78.6 vs 246.7 ± 55.4 ms, p < .5) and average R‐R interval (364.4 ± 37.9 vs 367.4 ± 77.5 ms, p < .5) measured during atrial fibrillation. The anterograde effective refractory period of the accessory pathway (292.1 ± 31.9 vs 299 ± 58.1 ms, p < .5) and the shortest cycle length with 1:1 conduction over the accessory pathway (306.7 ± 75 vs 289.1 ± 77.5 ms, p < .5) similarly did not differ. We conclude that syncope occurs in approximately 20% of patients with the Wolff‐Parkinson‐White syndrome referred for assessment of tachycardia. Patients with syncope do not have distinct clinical features or a more malignant electrophysiologic profile, suggesting that other extracardiac factors may play an important roe in the genesis of syncope in this group.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><label>*</label><p>Dr. Klein is a Senior Research Fellow of the Ontario Heart Foundation.</p></note><note xml:id="n-fnt-2" numbered="no"><p>This study was supported in part through funds provided by the Ontario Heart Foundation.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Syncope in the Wolff‐Parkinson‐White Syndrome: Incidence and Electrophysiologic Correlates</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Syncope in the Wolff‐Parkinson‐White Syndrome: Incidence and Electrophysiologic Correlates</title></titleInfo><name type="personal"><namePart type="given">RAYMOND</namePart><namePart type="family">YEE</namePart><affiliation>Clinical Electrophysiology Laboratory, University Hospital, London, Ontario</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">GEORGE J.</namePart><namePart type="family">KLEIN</namePart><affiliation>Clinical Electrophysiology Laboratory, University Hospital, London, Ontario</affiliation><description>Dr. Klein is a Senior Research Fellow of the Ontario Heart Foundation.</description><description>Correspondence: Address for reprints: George J. Klein, M.D., Cardiac Investigation Unit, University Hospital, P.O. 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We reviewed the records of 55 consecutive WPW patients referred for electrophysiologic evaluation of known or suspected arrhythmias to determine the incidence and significance of syncope. Twelve patients (22.6%) reported the occurrence of at least one episode of syncope. In eleven (20%) of these, syncope was preceded by rapid palpitations. Forty‐three patients (77.4%) had no syncopal episodes. These two groups did not differ significantly with regard to age, sex, presence of associated cardiac or neurologic disease, drug history or accessory pathway location. There was no significant difference in cycle length of reciprocating tachycardia (syncope = 295.6 ± 59.8 vs non‐syncope = 334.5 ± 59.6 ms, p < .5), shortest R‐R intervals between preexcited beats (260 ± 78.6 vs 246.7 ± 55.4 ms, p < .5) and average R‐R interval (364.4 ± 37.9 vs 367.4 ± 77.5 ms, p < .5) measured during atrial fibrillation. The anterograde effective refractory period of the accessory pathway (292.1 ± 31.9 vs 299 ± 58.1 ms, p < .5) and the shortest cycle length with 1:1 conduction over the accessory pathway (306.7 ± 75 vs 289.1 ± 77.5 ms, p < .5) similarly did not differ. We conclude that syncope occurs in approximately 20% of patients with the Wolff‐Parkinson‐White syndrome referred for assessment of tachycardia. Patients with syncope do not have distinct clinical features or a more malignant electrophysiologic profile, suggesting that other extracardiac factors may play an important roe in the genesis of syncope in this group.</abstract><subject lang="en"><genre>Keywords</genre><topic>Wolff‐Parkinson‐White syndrome</topic><topic>syncope</topic><topic>sudden death</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>1984</date><detail type="volume"><caption>vol.</caption><number>7</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>381</start><end>388</end><total>8</total></extent></part></relatedItem><identifier type="istex">EC97DF627F62A96D03B4F2C6B33B0C8E7D22EFD3</identifier><identifier type="DOI">10.1111/j.1540-8159.1984.tb04922.x</identifier><identifier type="ArticleID">PACE381</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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