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Electrophysiologic Evaluation of Asymptomatic Patients with the Wolff‐Parkinson‐White Pattern
Author(s) -
SATOH MASAHITO,
AIZAWA YOSHIFUSA,
FUNAZAKI TOSHIKAZU,
NIWANO SHINICHI,
EBE KATSUYA,
MIYAJIMA SEIICHI,
SUZUKI KAORU,
AIZAWA MASAMI,
SHIBATA AKIRA
Publication year - 1989
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1989.tb02678.x
Subject(s) - accessory pathway , medicine , asymptomatic , orthodromic , effective refractory period , tachycardia , cardiology , electrophysiologic study , paroxysmal tachycardia , anesthesia , atrial fibrillation , surgery , catheter ablation , electrophysiology
In the past 4 years, 34 asymptomatic patients with the Wolff‐Parkinson‐White (WPW) pattern underwent electrophysiologic study. The effective refractory period (ERP) of antegrade conduction over the accessory pathway was 288 ± 29 msec. In three asymptomatic patients (9%), the antegrade ERP of the accessory pathway was shorter than 250 msec. The antegrade ERP of the accessory pathway became shorter than 250 msec in an additional 12 of 22 (55%) patients after isoproterenol administration. Nineteen (56%) of the asymptomatic patients showed the absence of retrograde conduction over the accessory pathway even after isoproterenol administration. The rate of induction of orthodromic reciprocating tachycardia in the asymptomatic WPW patients was 15% (5/34), which was significantly lower than that in the symptomatic patients. These data suggest that in the asymptomatic patients, the absence of retrograde conduction over the accessory pathway is the reason they remained asymptomatic, free of reciprocating tachycardia. However, even in the asymptomatic patients, some had the accessory pathway in which antegrade ERP was shorter than 250 msec. They may result in rapid ventricular conduction over the accessory pathway when atrial fibrillation develops.