Limits...
Age-related location of manifest accessory pathway and clinical consequences.

Brembilla-Perrot B, Huttin O, Olivier A, Sellal JM, Villemin T, Manenti V, Moulin-Zinsch A, Marçon F, Simon G, Andronache M, Beurrier D, de Chillou C, Girerd N - Indian Pacing Electrophysiol J (2016)

Bottom Line: Maximal rate conducted over AP was significantly slower in patients with ASAP and RLAP than in other patients.Similar data were noted when AP location was confirmed at intracardiac EPS.Maximal rate conducted over AP was lower than in other locations.

View Article: PubMed Central - PubMed

Affiliation: Adult and Pediatric Cardiology, CHU de Brabois, Vandoeuvre Les Nancy, France.

ABSTRACT

Background: Accessory pathway (AP) ablation is not always easy. Our purpose was to assess the age-related prevalence of AP location, electrophysiological and prognostic data according to this location.

Methods: Electrophysiologic study (EPS) was performed in 994 patients for a pre-excitation syndrome. AP location was determined on a 12 lead ECG during atrial pacing at maximal preexcitation and confirmed at intracardiac EPS in 494 patients.

Results: AP location was classified as anteroseptal (AS)(96), right lateral (RL)(54), posteroseptal (PS)(459), left lateral (LL)(363), nodoventricular (NV)(22). Patients with ASAP or RLAP were younger than patients with another AP location. Poorly-tolerated arrhythmias were more frequent in patients with LLAP than in other patients (0.009 for ASAP, 0.0037 for RLAP, <0.0001 for PSAP). Maximal rate conducted over AP was significantly slower in patients with ASAP and RLAP than in other patients. Malignant forms at EPS were more frequent in patients with LLAP than in patients with ASAP (0.002) or PSAP (0.001). Similar data were noted when AP location was confirmed at intracardiac EPS. Among untreated patients, poorly-tolerated arrhythmia occurred in patients with LLAP (3) or PSAP (6). Failures of ablation were more frequent for AS or RL AP than for LL or PS AP.

Conclusions: AS and RLAP location in pre-excitation syndrome was more frequent in young patients. Maximal rate conducted over AP was lower than in other locations. Absence of poorly-tolerated arrhythmias during follow-up and higher risk of ablation failure should be taken into account for indications of AP ablation in children with few symptoms.

No MeSH data available.


Related in: MedlinePlus

Prevalence of AP location according to the age of patient. The legend represents the ranges of age (6–19 years).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4834439&req=5

fig2: Prevalence of AP location according to the age of patient. The legend represents the ranges of age (6–19 years).

Mentions: Male gender was significantly more frequent in patients with RL AP than in all other locations (87%) (p 0.01 for LL and PS location, 0.02 for AS AP) Fig. 2.


Age-related location of manifest accessory pathway and clinical consequences.

Brembilla-Perrot B, Huttin O, Olivier A, Sellal JM, Villemin T, Manenti V, Moulin-Zinsch A, Marçon F, Simon G, Andronache M, Beurrier D, de Chillou C, Girerd N - Indian Pacing Electrophysiol J (2016)

Prevalence of AP location according to the age of patient. The legend represents the ranges of age (6–19 years).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4834439&req=5

fig2: Prevalence of AP location according to the age of patient. The legend represents the ranges of age (6–19 years).
Mentions: Male gender was significantly more frequent in patients with RL AP than in all other locations (87%) (p 0.01 for LL and PS location, 0.02 for AS AP) Fig. 2.

Bottom Line: Maximal rate conducted over AP was significantly slower in patients with ASAP and RLAP than in other patients.Similar data were noted when AP location was confirmed at intracardiac EPS.Maximal rate conducted over AP was lower than in other locations.

View Article: PubMed Central - PubMed

Affiliation: Adult and Pediatric Cardiology, CHU de Brabois, Vandoeuvre Les Nancy, France.

ABSTRACT

Background: Accessory pathway (AP) ablation is not always easy. Our purpose was to assess the age-related prevalence of AP location, electrophysiological and prognostic data according to this location.

Methods: Electrophysiologic study (EPS) was performed in 994 patients for a pre-excitation syndrome. AP location was determined on a 12 lead ECG during atrial pacing at maximal preexcitation and confirmed at intracardiac EPS in 494 patients.

Results: AP location was classified as anteroseptal (AS)(96), right lateral (RL)(54), posteroseptal (PS)(459), left lateral (LL)(363), nodoventricular (NV)(22). Patients with ASAP or RLAP were younger than patients with another AP location. Poorly-tolerated arrhythmias were more frequent in patients with LLAP than in other patients (0.009 for ASAP, 0.0037 for RLAP, <0.0001 for PSAP). Maximal rate conducted over AP was significantly slower in patients with ASAP and RLAP than in other patients. Malignant forms at EPS were more frequent in patients with LLAP than in patients with ASAP (0.002) or PSAP (0.001). Similar data were noted when AP location was confirmed at intracardiac EPS. Among untreated patients, poorly-tolerated arrhythmia occurred in patients with LLAP (3) or PSAP (6). Failures of ablation were more frequent for AS or RL AP than for LL or PS AP.

Conclusions: AS and RLAP location in pre-excitation syndrome was more frequent in young patients. Maximal rate conducted over AP was lower than in other locations. Absence of poorly-tolerated arrhythmias during follow-up and higher risk of ablation failure should be taken into account for indications of AP ablation in children with few symptoms.

No MeSH data available.


Related in: MedlinePlus