0035: Unpredictable long-term follow-up of untreated preexcitation syndrome - 07/02/15
Résumé |
Background |
Accessory pathway (AP) ablation is currently performed in patients with a preexcitation syndrome (PS); natural follow-up is based on old studies. The purpose of the study was to report data of untreated patients with PS, studied 2 times at least one year of interval.
Methods |
2 baseline electrophysiological study (EPS) were performed within 1 to 25 years of one another (mean 9.5±7) in 104 patients, 58 males, 46 females, aged initially from 4 to 67 y (30±16), with overt PS. First EPS was indicated for syncope (n=10), atrioventricular reentrant tachycardias (AVRT)(n=51), atrial fibrillation (AF)(n=6), spontaneous malignant form (AF conducted at very high rates over AP)(n=4) or for asymptomatic PS (n= 33). The protocol was similar, performed in control state (CS) and after isoproterenol.
Results |
At 2nd EPS, among patients studied for syncope at EPS1, 2 have still syncope, 3 have AVRT, 1 has AF, 3 are asymptomatic. Among patients with AVRT at EPS1, 38 (74.5%) have AVRT, 8 are asymptomatic, 3 had syncope, 3 has AF. Among patients with AF, 2 present with a malignant form, 2 had AVRT, 1 is asymptomatic. Among asymptomatic patients, 3 present with a malignant form, 17 (53%) remain asymptomatic, 7 have AVRT, 4 have syncope, 1 has AF.All AVRT or AF but 1 occurred in patients with inducible AVRT or AF at EPS1.The higher rate conducted by AP was lower in CS and after isoproterenol at EPS2 (166±80bpm, 191±90) than at EPS1 (191±67, 243±67)(p<0.01). AP refractory periods increased from 268±73ms to 283±62 in CS (p<0.03) and from 202±46 to 244±54ms after isoproterenol (p<0.03). AP has lost anterograde conduction properties in 28 patients. AVRT was induced in 5 of 27 asymptomatic PS with initially negative EPS. Two patients with initially poor anterograde conduction over AP have a very rapid conduction over AP several years later.
Conclusions |
We generally report an improvement of electrophysiological data with the time; however AVRT induction remains present in 74.5% of cases; unexpected changes may occur in 2% of patients considered initially at low risk who developed a dramatic shortening of AP refractory period several years after initial measurement.
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Vol 7 - N° 1
P. 73 - janvier 2015 Retour au numéro
Article précédent
- 0034: Preexcitation syndrome and atrioventricular nodal reentrant tachycardia: coincidence or not?
- Beatrice Brembilla-Perrot, Arnaud Olivier, Vladimir Manenti, Jean Marc Sellal, Daniel Beurrier, Nicolas Girerd, Thibaut Villemin, Anne Moulin-Zinsch, Jean Paul Lethor, Damien Voilliot
- 0039: Elderly patients benefit from the evaluation of their tachycardia
- Béatrice Brembilla-Perrot, Vladimir Manenti, Arnaud Olivier, Jean-Marc Sellal, Thibaut Villemin, Daniel Beurrier, Arnaud Terrier De La Chaise, Olivier Selton, Pierre Louis, Damien Voilliot, Nicolas Girerd
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