Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages
Identifieur interne : 000229 ( Main/Corpus ); précédent : 000228; suivant : 000230Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages
Auteurs : Lynda E. Rosenfeld ; Alice M. Van Zetta ; William P. BatsfordSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1990.
Abstract
Although patients may develop arrhythmias due to preexcitation syndromes at any time from the prenatal period to late adulthood, presentation in late adulthood is considered uncommon and has not been well studied. From June 1981 to June 1989, 73 patients were documented to have preexcitation syndromes on the basis of electrophysiologic studies. Those whose initial arrhythmias appeared at an age >50 years (group 1, n = 13) were compared with the remaining 60 patients (group 2).All group 1 patients presented in the setting of acute medical or surgical diseases (n = 7), or chronic cardiac disease (n = 6) commonly associated with middle age and often with atrial arrhythmias; only 13 group 2 patients had underlying illnesses (p = 0.0001). Almost two-thirds of group 2 patients were evaluated because of narrow complex orthodromic tachycardia or palpitations and electrocardiographic evidence of preexcitation. Wide complex tachycardia was more often a reason for referral of older patients (7 of 13 vs 11 of 60, p < 0.05), among whom atrial fibrillation/flutter also tended to be more frequent (4 of 13 vs 11 of 60, difference not significant). The PR and QRS intervals of group 1 patients were within the normal range and differed significantly from those of group 2 patients (PR, 0.15 ± 0.04 vs 0.11 ± 0.03 second, p < 0.001; QRS, 0.09 ± 0.01 vs 0.12 ± 0.03 second, p < 0.001), making electrocardiographic identification of preexcitation more difficult in group 1. Several factors likely contributed. Concealed bypass tracts tended to appear more frequently in older patients (5 of 13 vs 8 of 60, p = 0.047), but intraatrial conduction delays as measured by the P-wave duration (103 ± 21 vs 90 ± 16 ms, p = 0.023), and the time from the onset of the P wave to the low right atrial electrogram (48 ± 19 vs 38 ± 15 ms, p = 0.042) may have contributed.Thus, as in infancy, specific age-related descriptors characterize patients presenting with preexcitation syndromes over the age of 50 years. Awareness of these descriptors will facilitate care of these adults.
Url:
DOI: 10.1016/0002-9149(91)90526-Q
Links to Exploration step
ISTEX:E6DED2786321D11D497CF40B9DA0E93C8477361DLe document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages</title><author><name sortKey="Rosenfeld, Lynda E" sort="Rosenfeld, Lynda E" uniqKey="Rosenfeld L" first="Lynda E." last="Rosenfeld">Lynda E. Rosenfeld</name><affiliation><mods:affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Van Zetta, Alice M" sort="Van Zetta, Alice M" uniqKey="Van Zetta A" first="Alice M." last="Van Zetta">Alice M. Van Zetta</name><affiliation><mods:affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Batsford, William P" sort="Batsford, William P" uniqKey="Batsford W" first="William P." last="Batsford">William P. Batsford</name><affiliation><mods:affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:E6DED2786321D11D497CF40B9DA0E93C8477361D</idno><date when="1991" year="1991">1991</date><idno type="doi">10.1016/0002-9149(91)90526-Q</idno><idno type="url">https://api.istex.fr/document/E6DED2786321D11D497CF40B9DA0E93C8477361D/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000229</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages</title><author><name sortKey="Rosenfeld, Lynda E" sort="Rosenfeld, Lynda E" uniqKey="Rosenfeld L" first="Lynda E." last="Rosenfeld">Lynda E. Rosenfeld</name><affiliation><mods:affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Van Zetta, Alice M" sort="Van Zetta, Alice M" uniqKey="Van Zetta A" first="Alice M." last="Van Zetta">Alice M. Van Zetta</name><affiliation><mods:affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Batsford, William P" sort="Batsford, William P" uniqKey="Batsford W" first="William P." last="Batsford">William P. Batsford</name><affiliation><mods:affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="ISSN">0002-9149</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1990">1990</date><biblScope unit="volume">67</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="709">709</biblScope><biblScope unit="page" to="712">712</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">E6DED2786321D11D497CF40B9DA0E93C8477361D</idno><idno type="DOI">10.1016/0002-9149(91)90526-Q</idno><idno type="PII">0002-9149(91)90526-Q</idno><idno type="ArticleID">9190526Q</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9149</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Although patients may develop arrhythmias due to preexcitation syndromes at any time from the prenatal period to late adulthood, presentation in late adulthood is considered uncommon and has not been well studied. From June 1981 to June 1989, 73 patients were documented to have preexcitation syndromes on the basis of electrophysiologic studies. Those whose initial arrhythmias appeared at an age >50 years (group 1, n = 13) were compared with the remaining 60 patients (group 2).All group 1 patients presented in the setting of acute medical or surgical diseases (n = 7), or chronic cardiac disease (n = 6) commonly associated with middle age and often with atrial arrhythmias; only 13 group 2 patients had underlying illnesses (p = 0.0001). Almost two-thirds of group 2 patients were evaluated because of narrow complex orthodromic tachycardia or palpitations and electrocardiographic evidence of preexcitation. Wide complex tachycardia was more often a reason for referral of older patients (7 of 13 vs 11 of 60, p < 0.05), among whom atrial fibrillation/flutter also tended to be more frequent (4 of 13 vs 11 of 60, difference not significant). The PR and QRS intervals of group 1 patients were within the normal range and differed significantly from those of group 2 patients (PR, 0.15 ± 0.04 vs 0.11 ± 0.03 second, p < 0.001; QRS, 0.09 ± 0.01 vs 0.12 ± 0.03 second, p < 0.001), making electrocardiographic identification of preexcitation more difficult in group 1. Several factors likely contributed. Concealed bypass tracts tended to appear more frequently in older patients (5 of 13 vs 8 of 60, p = 0.047), but intraatrial conduction delays as measured by the P-wave duration (103 ± 21 vs 90 ± 16 ms, p = 0.023), and the time from the onset of the P wave to the low right atrial electrogram (48 ± 19 vs 38 ± 15 ms, p = 0.042) may have contributed.Thus, as in infancy, specific age-related descriptors characterize patients presenting with preexcitation syndromes over the age of 50 years. Awareness of these descriptors will facilitate care of these adults.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Lynda E. Rosenfeld MD</name><affiliations><json:string>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</json:string></affiliations></json:item><json:item><name>Alice M. Van Zetta BSN</name><affiliations><json:string>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</json:string></affiliations></json:item><json:item><name>William P. Batsford MD</name><affiliations><json:string>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Arrhythmias and conduction disturbances</value></json:item></subject><articleId><json:string>9190526Q</json:string></articleId><language><json:string>eng</json:string></language><abstract>Although patients may develop arrhythmias due to preexcitation syndromes at any time from the prenatal period to late adulthood, presentation in late adulthood is considered uncommon and has not been well studied. From June 1981 to June 1989, 73 patients were documented to have preexcitation syndromes on the basis of electrophysiologic studies. Those whose initial arrhythmias appeared at an age >50 years (group 1, n = 13) were compared with the remaining 60 patients (group 2).All group 1 patients presented in the setting of acute medical or surgical diseases (n = 7), or chronic cardiac disease (n = 6) commonly associated with middle age and often with atrial arrhythmias; only 13 group 2 patients had underlying illnesses (p = 0.0001). Almost two-thirds of group 2 patients were evaluated because of narrow complex orthodromic tachycardia or palpitations and electrocardiographic evidence of preexcitation. Wide complex tachycardia was more often a reason for referral of older patients (7 of 13 vs 11 of 60, p > 0.05), among whom atrial fibrillation/flutter also tended to be more frequent (4 of 13 vs 11 of 60, difference not significant). The PR and QRS intervals of group 1 patients were within the normal range and differed significantly from those of group 2 patients (PR, 0.15 ± 0.04 vs 0.11 ± 0.03 second, p > 0.001; QRS, 0.09 ± 0.01 vs 0.12 ± 0.03 second, p > 0.001), making electrocardiographic identification of preexcitation more difficult in group 1. Several factors likely contributed. Concealed bypass tracts tended to appear more frequently in older patients (5 of 13 vs 8 of 60, p = 0.047), but intraatrial conduction delays as measured by the P-wave duration (103 ± 21 vs 90 ± 16 ms, p = 0.023), and the time from the onset of the P wave to the low right atrial electrogram (48 ± 19 vs 38 ± 15 ms, p = 0.042) may have contributed.Thus, as in infancy, specific age-related descriptors characterize patients presenting with preexcitation syndromes over the age of 50 years. Awareness of these descriptors will facilitate care of these adults.</abstract><qualityIndicators><score>5.6</score><pdfVersion>1.3</pdfVersion><pdfPageSize>575.84 x 827.84 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>1</keywordCount><abstractCharCount>2066</abstractCharCount><pdfWordCount>2600</pdfWordCount><pdfCharCount>16775</pdfCharCount><pdfPageCount>4</pdfPageCount><abstractWordCount>345</abstractWordCount></qualityIndicators><title>Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages</title><pii><json:string>0002-9149(91)90526-Q</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>67</volume><pii><json:string>S0002-9149(00)X0836-3</json:string></pii><pages><last>712</last><first>709</first></pages><issn><json:string>0002-9149</json:string></issn><issue>8</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>The American Journal of Cardiology</title><publicationDate>1991</publicationDate></host><publicationDate>1990</publicationDate><copyrightDate>1991</copyrightDate><doi><json:string>10.1016/0002-9149(91)90526-Q</json:string></doi><id>E6DED2786321D11D497CF40B9DA0E93C8477361D</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/E6DED2786321D11D497CF40B9DA0E93C8477361D/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/E6DED2786321D11D497CF40B9DA0E93C8477361D/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/E6DED2786321D11D497CF40B9DA0E93C8477361D/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/E6DED2786321D11D497CF40B9DA0E93C8477361D/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1991</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages</title><author><persName><forename type="first">Lynda E.</forename><surname>Rosenfeld</surname></persName><roleName type="degree">MD</roleName><note type="biography">Address for reprints: Lynda E. Rosenfeld, MD, Section of Cardiovascular Medicine 3FMP, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.</note><affiliation>Address for reprints: Lynda E. Rosenfeld, MD, Section of Cardiovascular Medicine 3FMP, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.</affiliation><affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</affiliation></author><author><persName><forename type="first">Alice M.</forename><surname>Van Zetta</surname></persName><roleName type="degree">BSN</roleName><affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</affiliation></author><author><persName><forename type="first">William P.</forename><surname>Batsford</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</affiliation></author></analytic><monogr><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="pISSN">0002-9149</idno><idno type="PII">S0002-9149(00)X0836-3</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1990"></date><biblScope unit="volume">67</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="709">709</biblScope><biblScope unit="page" to="712">712</biblScope></imprint></monogr><idno type="istex">E6DED2786321D11D497CF40B9DA0E93C8477361D</idno><idno type="DOI">10.1016/0002-9149(91)90526-Q</idno><idno type="PII">0002-9149(91)90526-Q</idno><idno type="ArticleID">9190526Q</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1991</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Although patients may develop arrhythmias due to preexcitation syndromes at any time from the prenatal period to late adulthood, presentation in late adulthood is considered uncommon and has not been well studied. From June 1981 to June 1989, 73 patients were documented to have preexcitation syndromes on the basis of electrophysiologic studies. Those whose initial arrhythmias appeared at an age >50 years (group 1, n = 13) were compared with the remaining 60 patients (group 2).All group 1 patients presented in the setting of acute medical or surgical diseases (n = 7), or chronic cardiac disease (n = 6) commonly associated with middle age and often with atrial arrhythmias; only 13 group 2 patients had underlying illnesses (p = 0.0001). Almost two-thirds of group 2 patients were evaluated because of narrow complex orthodromic tachycardia or palpitations and electrocardiographic evidence of preexcitation. Wide complex tachycardia was more often a reason for referral of older patients (7 of 13 vs 11 of 60, p < 0.05), among whom atrial fibrillation/flutter also tended to be more frequent (4 of 13 vs 11 of 60, difference not significant). The PR and QRS intervals of group 1 patients were within the normal range and differed significantly from those of group 2 patients (PR, 0.15 ± 0.04 vs 0.11 ± 0.03 second, p < 0.001; QRS, 0.09 ± 0.01 vs 0.12 ± 0.03 second, p < 0.001), making electrocardiographic identification of preexcitation more difficult in group 1. Several factors likely contributed. Concealed bypass tracts tended to appear more frequently in older patients (5 of 13 vs 8 of 60, p = 0.047), but intraatrial conduction delays as measured by the P-wave duration (103 ± 21 vs 90 ± 16 ms, p = 0.023), and the time from the onset of the P wave to the low right atrial electrogram (48 ± 19 vs 38 ± 15 ms, p = 0.042) may have contributed.Thus, as in infancy, specific age-related descriptors characterize patients presenting with preexcitation syndromes over the age of 50 years. Awareness of these descriptors will facilitate care of these adults.</p></abstract><textClass><keywords scheme="keyword"><list><head>Article category</head><item><term>Arrhythmias and conduction disturbances</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1990-11-28">Registration</change><change when="1990">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>AJC</jid><aid>9190526Q</aid><ce:pii>0002-9149(91)90526-Q</ce:pii><ce:doi>10.1016/0002-9149(91)90526-Q</ce:doi><ce:copyright type="unknown" year="1991"></ce:copyright><ce:doctopics><ce:doctopic><ce:text>Arrhythmias and conduction disturbances</ce:text></ce:doctopic></ce:doctopics></item-info><head><ce:title>Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages</ce:title><ce:author-group><ce:author><ce:given-name>Lynda E.</ce:given-name><ce:surname>Rosenfeld</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Alice M.</ce:given-name><ce:surname>Van Zetta</ce:surname><ce:degrees>BSN</ce:degrees></ce:author><ce:author><ce:given-name>William P.</ce:given-name><ce:surname>Batsford</ce:surname><ce:degrees>MD</ce:degrees></ce:author><ce:affiliation><ce:textfn>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Lynda E. Rosenfeld, MD, Section of Cardiovascular Medicine 3FMP, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="6" month="9" year="1990"></ce:date-received><ce:date-accepted day="28" month="11" year="1990"></ce:date-accepted><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">Although patients may develop arrhythmias due to preexcitation syndromes at any time from the prenatal period to late adulthood, presentation in late adulthood is considered uncommon and has not been well studied. From June 1981 to June 1989, 73 patients were documented to have preexcitation syndromes on the basis of electrophysiologic studies. Those whose initial arrhythmias appeared at an age >50 years (group 1, n = 13) were compared with the remaining 60 patients (group 2).</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">All group 1 patients presented in the setting of acute medical or surgical diseases (n = 7), or chronic cardiac disease (n = 6) commonly associated with middle age and often with atrial arrhythmias; only 13 group 2 patients had underlying illnesses (p = 0.0001). Almost two-thirds of group 2 patients were evaluated because of narrow complex orthodromic tachycardia or palpitations and electrocardiographic evidence of preexcitation. Wide complex tachycardia was more often a reason for referral of older patients (7 of 13 vs 11 of 60, p < 0.05), among whom atrial fibrillation/flutter also tended to be more frequent (4 of 13 vs 11 of 60, difference not significant). The PR and QRS intervals of group 1 patients were within the normal range and differed significantly from those of group 2 patients (PR, 0.15 ± 0.04 vs 0.11 ± 0.03 second, p < 0.001; QRS, 0.09 ± 0.01 vs 0.12 ± 0.03 second, p < 0.001), making electrocardiographic identification of preexcitation more difficult in group 1. Several factors likely contributed. Concealed bypass tracts tended to appear more frequently in older patients (5 of 13 vs 8 of 60, p = 0.047), but intraatrial conduction delays as measured by the P-wave duration (103 ± 21 vs 90 ± 16 ms, p = 0.023), and the time from the onset of the P wave to the low right atrial electrogram (48 ± 19 vs 38 ± 15 ms, p = 0.042) may have contributed.</ce:simple-para><ce:simple-para view="all" id="simple-para.0020">Thus, as in infancy, specific age-related descriptors characterize patients presenting with preexcitation syndromes over the age of 50 years. Awareness of these descriptors will facilitate care of these adults.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages</title></titleInfo><name type="personal"><namePart type="given">Lynda E.</namePart><namePart type="family">Rosenfeld</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</affiliation><description>Address for reprints: Lynda E. Rosenfeld, MD, Section of Cardiovascular Medicine 3FMP, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06510.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alice M.</namePart><namePart type="family">Van Zetta</namePart><namePart type="termsOfAddress">BSN</namePart><affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">William P.</namePart><namePart type="family">Batsford</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1990</dateIssued><dateValid encoding="w3cdtf">1990-11-28</dateValid><copyrightDate encoding="w3cdtf">1991</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Although patients may develop arrhythmias due to preexcitation syndromes at any time from the prenatal period to late adulthood, presentation in late adulthood is considered uncommon and has not been well studied. From June 1981 to June 1989, 73 patients were documented to have preexcitation syndromes on the basis of electrophysiologic studies. Those whose initial arrhythmias appeared at an age >50 years (group 1, n = 13) were compared with the remaining 60 patients (group 2).All group 1 patients presented in the setting of acute medical or surgical diseases (n = 7), or chronic cardiac disease (n = 6) commonly associated with middle age and often with atrial arrhythmias; only 13 group 2 patients had underlying illnesses (p = 0.0001). Almost two-thirds of group 2 patients were evaluated because of narrow complex orthodromic tachycardia or palpitations and electrocardiographic evidence of preexcitation. Wide complex tachycardia was more often a reason for referral of older patients (7 of 13 vs 11 of 60, p < 0.05), among whom atrial fibrillation/flutter also tended to be more frequent (4 of 13 vs 11 of 60, difference not significant). The PR and QRS intervals of group 1 patients were within the normal range and differed significantly from those of group 2 patients (PR, 0.15 ± 0.04 vs 0.11 ± 0.03 second, p < 0.001; QRS, 0.09 ± 0.01 vs 0.12 ± 0.03 second, p < 0.001), making electrocardiographic identification of preexcitation more difficult in group 1. Several factors likely contributed. Concealed bypass tracts tended to appear more frequently in older patients (5 of 13 vs 8 of 60, p = 0.047), but intraatrial conduction delays as measured by the P-wave duration (103 ± 21 vs 90 ± 16 ms, p = 0.023), and the time from the onset of the P wave to the low right atrial electrogram (48 ± 19 vs 38 ± 15 ms, p = 0.042) may have contributed.Thus, as in infancy, specific age-related descriptors characterize patients presenting with preexcitation syndromes over the age of 50 years. Awareness of these descriptors will facilitate care of these adults.</abstract><subject><genre>Article category</genre><topic>Arrhythmias and conduction disturbances</topic></subject><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">19910401</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(00)X0836-3</identifier><part><date>19910401</date><detail type="volume"><number>67</number><caption>vol.</caption></detail><detail type="issue"><number>8</number><caption>no.</caption></detail><extent unit="issue pages"><start>A3</start><end>A48</end></extent><extent unit="issue pages"><start>A60</start></extent><extent unit="issue pages"><start>A69</start><end>A70</end></extent><extent unit="issue pages"><start>A71</start></extent><extent unit="issue pages"><start>A74</start></extent><extent unit="issue pages"><start>A78</start></extent><extent unit="issue pages"><start>A83</start><end>A84</end></extent><extent unit="issue pages"><start>A85</start><end>A86</end></extent><extent unit="issue pages"><start>665</start><end>788</end></extent><extent unit="pages"><start>709</start><end>712</end></extent></part></relatedItem><identifier type="istex">E6DED2786321D11D497CF40B9DA0E93C8477361D</identifier><identifier type="DOI">10.1016/0002-9149(91)90526-Q</identifier><identifier type="PII">0002-9149(91)90526-Q</identifier><identifier type="ArticleID">9190526Q</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:refBibTEI uri="https://api.istex.fr/document/E6DED2786321D11D497CF40B9DA0E93C8477361D/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><analytic><title level="a" type="main">Bundle-branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia. Am Hear?</title><author><persName><forename type="middle">L</forename><surname>Wolff</surname></persName></author><author><persName><forename type="middle">J</forename><surname>Parkinson</surname></persName></author><author><persName><surname>White</surname></persName></author></analytic><monogr><title level="j">J</title><imprint><biblScope unit="volume">6</biblScope><biblScope unit="page" from="685" to="704"></biblScope><date type="published" when="1930"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">The Wolff-Parkinson-White syn-drome in infants and children</title><author><persName><surname>Schiebler</surname></persName></author><author><persName><surname>Gl</surname></persName></author><author><persName><surname>Adams</surname></persName></author><author><persName><surname>Jr</surname></persName></author><author><persName><surname>Anderson</surname></persName></author></analytic><monogr><title level="j">Pediatrics</title><imprint><biblScope unit="volume">24</biblScope><biblScope unit="page" from="585" to="603"></biblScope><date type="published" when="1959"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Wolff-Parkinson-White syndrome in infants and children</title><author><persName><forename type="first">Ehlers</forename><forename type="middle">Kh</forename><surname>Giardina Acv</surname></persName></author><author><persName><surname>Engle</surname></persName></author><author><persName><surname>Ma</surname></persName></author></analytic><monogr><title level="j">Br Heart J</title><imprint><biblScope unit="volume">34</biblScope><biblScope unit="page" from="839" to="846"></biblScope><date type="published" when="1972"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Paroxysmal tachycardia in infancy: follow-up study of 47 subjects ranging in age from 10 to 26 years</title><author><persName><forename type="middle">A</forename><surname>Lundberg</surname></persName></author></analytic><monogr><title level="j">Pediatrics</title><imprint><biblScope unit="volume">51</biblScope><biblScope unit="page" from="26" to="35"></biblScope><date type="published" when="1973"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Transient Wolff-Parkinson-White syndrome and neonatal reciprocating tachycardia</title><author><persName><surname>Moene Rj</surname></persName></author><author><persName><surname>Jp</surname></persName></author></analytic><monogr><title level="j">Circulation</title><imprint><biblScope unit="volume">48</biblScope><biblScope unit="page" from="443" to="447"></biblScope><date type="published" when="1973"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Supraventricular tachycardia in children: clinical features, response to treatment, and long-term follow-up in 217 patients</title><author><persName><surname>Garson</surname></persName></author><author><persName><surname>Jr</surname></persName></author><author><persName><forename type="middle">Pc</forename><surname>Gillette</surname></persName></author><author><persName><surname>Mcnamara</surname></persName></author></analytic><monogr><title level="j">J Pediatr</title><imprint><biblScope unit="volume">98</biblScope><biblScope unit="page" from="875" to="882"></biblScope><date type="published" when="1981"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Wolff-Parkinson-White syndrome in the neonate</title><author><persName><surname>Wolff</surname></persName></author><author><persName><forename type="first">Han</forename><forename type="middle">J</forename><surname>Gs</surname></persName></author><author><persName><surname>Curran</surname></persName></author></analytic><monogr><title level="j">Am J Cardi ol</title><imprint><biblScope unit="volume">41</biblScope><biblScope unit="page" from="559" to="563"></biblScope><date type="published" when="1978"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Natural history of Wolff-Parkinson-White syndrome discovered in infancy</title><author><persName><forename type="first">Mantakas</forename><forename type="middle">Me Cm</forename><surname>Mccue</surname></persName></author><author><persName><surname>Miller</surname></persName></author></analytic><monogr><title level="j">Am J Cardi ol</title><imprint><biblScope unit="volume">41</biblScope><biblScope unit="page" from="1097" to="1103"></biblScope><date type="published" when="1978"></date></imprint></monogr></biblStruct><biblStruct><monogr><title level="m" type="main">Wolff-Parkinson-White syn-drome and supraventricular tachycardia during infancy: management and follow-up. .I Am Co11 Cardi ol</title><author><persName><forename type="middle">Bj</forename><surname>Deal</surname></persName></author><author><persName><forename type="middle">Jf</forename><surname>Keane</surname></persName></author><author><persName><surname>Gillette Pc</surname></persName></author><author><persName><surname>Garson</surname></persName></author><author><persName><surname>Jr</surname></persName></author><imprint><date type="published" when="1985"></date><biblScope unit="page" from="130" to="135"></biblScope></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Two accessory pathways, dual AV nodal con-duction, and I:2 ventriculoatrial conduction in a patient with multiple supraven-tricular tachycardias</title><author><persName><forename type="first">Rosenfeld</forename><forename type="middle">Le</forename><surname>Batsford</surname></persName></author><author><persName><surname>Wp</surname></persName></author></analytic><monogr><title level="j">PACE</title><imprint><biblScope unit="volume">13</biblScope><biblScope unit="page" from="171" to="178"></biblScope><date type="published" when="1990"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Wolff-Parkinson-White syndrome</title><author><persName><surname>Flensted-Jensen</surname></persName></author></analytic><monogr><title level="j">Acta Med Stand</title><imprint><biblScope unit="volume">186</biblScope><biblScope unit="page" from="65" to="74"></biblScope><date type="published" when="1969"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Manifestation of the Wolff-Parkinson-White syndrome after myocardial infarction</title><author><persName><forename type="first">Gael</forename><forename type="middle">Bg</forename><surname>Han</surname></persName></author></analytic><monogr><title level="j">Am Heart J</title><imprint><biblScope unit="volume">87</biblScope><biblScope unit="page" from="633" to="636"></biblScope><date type="published" when="1974"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Long-term status and survival in Wolff-Parkinson-White syndrome</title><author><persName><surname>Proudtit Wl</surname></persName></author><author><persName><surname>Sterba</surname></persName></author></analytic><monogr><title level="j">Cleve Clin J Med</title><imprint><biblScope unit="volume">56</biblScope><biblScope unit="page" from="601" to="606"></biblScope><date type="published" when="1989"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Longitudinal electrophysiologic assessment of asymptomatic patients with the Wolff-Parkinson-White electrocardiographic pat-tern</title><author><persName><surname>Klein</surname></persName></author><author><persName><forename type="first">Yee</forename><forename type="middle">R</forename><surname>Gj</surname></persName></author><author><persName><surname>Sharma</surname></persName></author></analytic><monogr><title level="j">N Engl J Med</title><imprint><biblScope unit="volume">320</biblScope><biblScope unit="page" from="1229" to="1233"></biblScope><date type="published" when="1989"></date></imprint></monogr></biblStruct><biblStruct><analytic><title level="a" type="main">Electrophysiologic profile of asymptomat-ic Wolff-Parkinson-White pattern</title><author><persName><forename type="middle">S</forename><surname>Milstein</surname></persName></author><author><persName><forename type="middle">Ad</forename><surname>Sharma</surname></persName></author><author><persName><surname>Klein</surname></persName></author></analytic><monogr><title level="j">Am J Cardi ol</title><imprint><biblScope unit="volume">57</biblScope><biblScope unit="page" from="1097" to="1100"></biblScope><date type="published" when="1986"></date></imprint></monogr></biblStruct></listBibl></back></text></istex:refBibTEI></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonV1/Data/Main/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000229 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Corpus/biblio.hfd -nk 000229 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= ParkinsonV1
|flux= Main
|étape= Corpus
|type= RBID
|clé= ISTEX:E6DED2786321D11D497CF40B9DA0E93C8477361D
|texte= Comparison of clinical and electrophysiologic features of preexcitation syndromes in patients presenting initially after age 50 years with those presenting at younger ages
}}
| This area was generated with Dilib version V0.6.23. |  |