1. The impact of age on the electrophysiological characteristics and different arrhythmia patterns in patients with Wolff-Parkinson-White syndrome.
- Author
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Li CH, Hu YF, Lin YJ, Chang SL, Lo LW, Ta-Chuan T, Lee PC, Huang SY, Suenari K, Tung NH, Tai CT, Chao TF, Chiang CE, and Chen SA
- Subjects
- Accessory Atrioventricular Bundle surgery, Action Potentials, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Catheter Ablation, Chi-Square Distribution, Child, Electrocardiography, Female, Heart Conduction System surgery, Humans, Male, Middle Aged, Predictive Value of Tests, Radiography, Interventional, Refractory Period, Electrophysiological, Taiwan, Time Factors, Treatment Outcome, Wolff-Parkinson-White Syndrome physiopathology, Wolff-Parkinson-White Syndrome surgery, Young Adult, Accessory Atrioventricular Bundle physiopathology, Electrophysiologic Techniques, Cardiac, Heart Conduction System physiopathology, Wolff-Parkinson-White Syndrome diagnosis
- Abstract
Introduction: Information about the impact of age on the electrophysiological characteristics of accessory pathways (APs) in patients with Wolff-Parkinson-White (WPW) syndrome remains limited., Methods and Results: A total of 1,885 consecutive patients (mean age 43 ± 17 years, male 61.5%) with WPW syndrome who were referred to the tertiary center for an electrophysiological study and radiofrequency catheter ablation were investigated. The patients were divided into 4 groups based on their age (Group 1: <20; Group 2: 20-39; Group 3: 40-59; Group 4: ≧60 years old). With age, more left-sided APs (53.2%, 67.7%, 71.7%, 75.7%, P < 0.001) and a longer duration of the arrhythmia (4.3 ± 2.8 years, 10.1 ± 7.0 years, 12.4 ± 10.9 years, 14.0 ± 12.4 years, P < 0.001) were noted. The incidence of concealed APs (53.5%, 53.0%, 57.8%, 60.9%, P = 0.01), and orthodromic atrioventricular (AV) reentrant tachycardia (92.4%, 94.2%, 96.5%, 96.3%, P = 0.023) increased with age. The tachycardia cycle length, antegrade (275.5 ± 42.2 ms, 286.7 ± 62.7 ms, 302.5 ± 66.5 ms, 315.2 ± 80.2 ms, P < 0.001) and retrograde AP effective refractory periods (APERPs) (254.0 ± 42.5 ms, 263.3 ± 51.8 ms, 274.5 ± 100.5 ms, 292.7 ± 57.0 ms, P < 0.001), atrial ERP, antegrade AV node effective refractory period (AVNERP), and ventricular effective refractory period (VERP) lengthened as the age increased. The incidence of decremental APs, multiple APs, and a catecholamine response were similar. The duration of the catheter ablation, total fluoroscopy time, acute success rate, complication rate, and incidence of a secondary procedure were similar between the different age groups., Conclusion: The electrophysiological characteristics and pattern of the arrhythmic attack associated with the AP changed with age., (© 2010 Wiley Periodicals, Inc.)
- Published
- 2011
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