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Increased P wave dispersion after the radiofrequency catheter ablation in overt pre-excitation patients: the role of atrial vulnerability.
Soylu, Mustafa; Demir, Ahmet Duran; Ozdemir, Ozcan; Soylu, Ozer; Topaloglu, Serkan; Korkmaz, Sule; Sasmaz, Ali.
Affiliation
  • Soylu M; Department of Cardiology, Yüksek Ihtisas Hospital, Ankara, Turkey.
Int J Cardiol ; 95(2-3): 167-70, 2004 Jun.
Article in En | MEDLINE | ID: mdl-15193815
ABSTRACT
The pathogenesis of paroxysmal atrial fibrillation (PAF) in patients with overt pre-excitation and effect of elimination of accessory pathways on the appearance of AF are still controversial. We demonstrated the increased P max and P wave dispersion (PWD) reflecting more inhomogeneous and prolonged atrial conduction in patients with Wolff-Parkinson-White (WPW) syndrome and PAF attacks. One-hundred and fifty-one patients who underwent radiofrequency (RF) catheter ablation due to paroxysmal tachycardia medicated by accessory pathway were enrolled in this study. The patients were classified into two groups according to the presence of previous PAF attacks. We compared the clinical characteristics, echocardiograhic findings, P max and PWD values measured after normalization of PR intervals and disappearance of pre-excitation after ablation in overt pre-excitation patients. Although the differences in age, left atrial diameter and left ventricular ejection fraction (LVEF) were not significant in both groups, P maximum (130.0+/-8.4 vs. 122.3+/-8.7 ms, p=0.002) and P wave dispersion values measured after ablation (50.3+/-7.2 vs. 35.7+/-6.1 ms, p=0.001) were significantly higher in patients with previous PAF attacks. Accessory pathway (AP) antegrade and retrograde effective refractory period (ERP) values were shorter (276+/-27.3 vs. 321.0+/-48.7, p=0.001; 263.4+/-41.3 vs. 299.7+/-38.2, p=0.002, respectively) in patients with PAF attack when compared to those without PAF attacks. Higher P wave dispersion values in patients with previous PAF attacks suggest the important role of inhomogenous and discontinuous propagation of sinus impulses. Therefore, we concluded that not only the accessory pathway but also inhomogenous propagation of sinus impulses may play an important role in occurrence of AF in patients with pre-excitation.
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Collection: 01-internacional Database: MEDLINE Main subject: Atrial Fibrillation / Tachycardia, Paroxysmal / Wolff-Parkinson-White Syndrome / Catheter Ablation / Heart Conduction System Type of study: Observational_studies Limits: Adult / Female / Humans / Male Language: En Journal: Int J Cardiol Year: 2004 Document type: Article Affiliation country: Turkey
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Collection: 01-internacional Database: MEDLINE Main subject: Atrial Fibrillation / Tachycardia, Paroxysmal / Wolff-Parkinson-White Syndrome / Catheter Ablation / Heart Conduction System Type of study: Observational_studies Limits: Adult / Female / Humans / Male Language: En Journal: Int J Cardiol Year: 2004 Document type: Article Affiliation country: Turkey