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- Clinical Approaches to Tachyarrhythmias, Volume 6, The Wolff-Parkinson-White Syndrome | Wiley.
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Escudero MD b Andrew D. Blaufox MD c Ian H. Law MD d Brynn E.
Stephenson MD f Anne M. Dubin MD g Scott R. Ceresnak MD g Kara S. Motonaga MD g Jonathan R. Marcondes MD h James C. Tatar, C. Lethor, J. Tisserand, A. Admant, P. Belhadj, K. Simon, J.
Benzhagou, N. Ladusans, Edmund J. Diagnosis, evaluation and treatment of cardiac arrhythmias. Paediatrics and Child Health, Vol. Pediatric Cardiology, Vol. Tachycardie de la jonction auriculoventriculaire. EMC - Cardiologie, Vol. Ko, Jae K. Kim, Young H. Chaotic atrial tachycardia-related ventricular fibrillation in a 2-month-old baby with Wolff-Pakinson-White syndrome. Obeyesekere, Manoj N. Skanes, Allan C.
Yee, Raymond Gula, Lorne J. Circulation, Vol. Pappone, Carlo and Santinelli, Vincenzo Cardiac Electrophysiology Clinics, Vol. Sellal, J.
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Schwartz, J. Olivier, A. Zinzius, P. De Chillou, C. Beurrier, D. Rodermann, M. Goudote, G. Al Amoura, H. Terrier de la Chaise, A. Lemoine, J. Rizk, J. Anne Tisserand, J. Obeyesekere, Manoj and Klein, George J. Does the age of evaluation change the long-term follow-up of untreated pre-excitation syndrome? Journal of Electrocardiology, Vol. Encyclopedia of Cardiovascular Research and Medicine.
Reference Module in Biomedical Sciences. Google Scholar Citations. Scopus Citations. Check if you have access via personal or institutional login. Log in Register. Export citation Request permission. References Hide All. High frequency alternating current abalation of an accessory pathway in humans.
J Am Coll Cardiol ; 10 : — Comparison,adolescents, and adukts and the impact of accessoty pathway location. Am L Cardiol ; 74 , — Follow up of radiofrequency catherter ablation in children: results in consecutive patients. J Am Coll Cardiol ; 23 : — Five-year experience with radiofrequency catheterblation: implications for management of arrhythmias in pediatric and young adult patients. J pediatrics ; : — Kugler , JD.
In the three largest series of patients with the Wolff—Parkinson—White syndrome and documented ventricular fibrillation, the arrhythmia was the presenting symptom in 3 of 25 patients, 9 6 of 23 patients, 10 and 8 of 15 patients, 11 and these findings were rarely observed in patients over 30 years of age.
In addition, we have shown that ventricular fibrillation or sudden death may be preceded by only minimally symptomatic atrial fibrillation, despite an extremely rapid ventricular response over accessory pathways. Our previous experience 2 and the present study contrast with previous studies that have found the Wolff—Parkinson—White electrocardiographic pattern in asymptomatic patients to be associated with a good prognosis.
Although the risk of fatal complications has been reported to be as high as 0. Thus, we suggest expanding recommendations for invasive evaluation of asymptomatic patients with the Wolff—Parkinson—White syndrome. Patients without inducible arrhythmias do not require prophylactic ablation, since they remain asymptomatic for many years. Young patients with inducible arrhythmias may be divided into two subgroups.
In those with inducible atrioventricular reciprocating tachycardia, whether or not it triggers sustained atrial fibrillation, ablation is mandatory, since arrhythmic events usually occur earlier. On the other hand, in patients with inducible, nonsustained atrial fibrillation, ablation may be deferred, because arrhythmic events are rare and usually develop later in life. Our observations and conclusions should be interpreted in the light of the limitations imposed by an unblinded randomization.
Our results were obtained at two institutions with high volumes of ablation procedures; therefore, these results may not be directly applicable to all institutions performing ablation therapy. Because none of our patients were younger than 13 years of age, these results are not applicable to children or infants, who represent a critical group for catheter ablation because of their low body weight, which has been shown to be a major risk factor for complications.
Furthermore, the true rate of multiple accessory pathways might be higher, because we did not include children. Finally, the choice of an age cutoff of 35 years was arbitrary. However, our recently published data 2 and the data from this study confirm that the use of this cutoff may identify patients with inducible arrhythmias who will become symptomatic. Address reprint requests to Dr. Should patients with asymptomatic Wolff-Parkinson-White pattern undergo a catheter ablation?
Risk of Malignant Arrhythmias in Initially Symptomatic Patients With Wolff-Parkinson-White Syndrome
Curr Cardiol Rep ;3: - Usefulness of invasive electrophysiologic testing to stratify the risk of arrhythmic events in asymptomatic patients with Wolff-Parkinson-White pattern: results from a large prospective long-term follow-up study. J Am Coll Cardiol ; - Atrioventricular nodal reentry and dual atrioventricular node physiology in patients undergoing accessory pathway ablation.
Am J Cardiol ; - Effect of dual atrioventricular node pathways on atrioventricular reentrant tachycardia. Circulation ; - Prognostic value of electrophysiology testing in asymptomatic patients with Wolff-Parkinson-White pattern. Circulation ; - [Erratum, Circulation ; The Wolff-Parkinson-White electrocardiogram: a follow-up study of five to twenty-eight years.
N Engl J Med ; - A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, to The natural history of Wolff-Parkinson-White syndrome in military aviators: a long-term follow-up of 22 years. Am Heart J ; - Ventricular fibrillation in the Wolff-Parkinson-White syndrome. Eur Heart J ; - Aborted sudden death in the Wolff-Parkinson-White syndrome. Multiple accessory pathways in the Wolff-Parkinson-White syndrome as a risk factor for ventricular fibrillation.
Longitudinal electrophysiologic assessment of asymptomatic patients with the Wolff-Parkinson-White electrocardiographic pattern. Electrophysiologic evaluation of asymptomatic patients with the Wolff-Parkinson-White pattern.
Pacing Clin Electrophysiol ; - The predictive value of electrophysiologic studies in untreated patients with the Wolff-Parkinson-White syndrome. Brembilla-Perrot B, Ghawi R. Electrophysiological characteristics of asymptomatic Wolff-Parkinson-White syndrome. Ventricular pre-excitation in the general population: a study on the mode of presentation and clinical course. Heart ; 29 - Asymptomatic Wolff-Parkinson-White syndrome: is it time to revisit guidelines? Close References. Close Citing Articles. Methods From to , among eligible asymptomatic patients with the Wolff—Parkinson—White syndrome, patients at high risk for arrhythmias were randomly assigned to radio-frequency catheter ablation of accessory pathways 37 patients or no treatment 35 patients.
Results Patients assigned to ablation had base-line characteristics that were similar to those of the controls. Conclusions Prophylactic accessory-pathway ablation markedly reduces the frequency of arrhythmic events in asymptomatic patients with the Wolff—Parkinson—White syndrome who are at high risk for such events.
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