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. 2023 Sep;46(9):1049-1055.
doi: 10.1111/pace.14798. Epub 2023 Aug 1.

Intermittent ventricular pre-excitation in symptomatic adults: Always a marker of low risk?

Antonio Gianluca Robles  1   2 , Zefferino Palamà  1   3 , Andrej Pernat  4 , Domenico Gianfrancesco  2 , Francesco Bartolomucci  2 , Antonio Scarà  5 , Alessio Borrelli  5 , Ermenegildo De Ruvo  6 , Leonardo Calò  6 , Maria Penco  1 , Silvio Romano  1 , Luigi Sciarra  1   5
Affiliations

Intermittent ventricular pre-excitation in symptomatic adults: Always a marker of low risk?

Antonio Gianluca Robles et al. Pacing Clin Electrophysiol. 2023 Sep.

Abstract

Background: Intermittent ventricular pre-excitation was considered a low-risk marker for sudden death. However, to date, some studies do not exclude the existence of accessory pathways (APs) with high-risk intermittent antegrade conductive properties. According to current European Guidelines, high-risk features of APs are antegrade pathway conduction ≤250 ms in baseline or during the adrenergic stimulus, inducibility of atrioventricular reciprocating tachycardias (AVRT), inducibility of pre-excited atrial fibrillation (AF), and presence of multiple APs. For all of these transcatheter ablation is recommended. The aim of our study was to evaluate the existence of differences in risk characteristics between patients with intermittent pre-excitation (IPX) and those with persistent pre-excitation (PPX), from a sample of adults with ventricular pre-excitation and symptoms like palpitations.

Methods: 293 adults [IPX: 51 (17.4%); PPX: 242 (82.6%)] underwent electrophysiological study and then catheter ablation of their APs if arrhythmia inducibility (AVRT/AF) was noted, or, conversely, if it was appreciated a fast AP antegrade conduction, in baseline or during intravenous isoproterenol infusion, or if multiple APs were detected.

Results: There were no statistically significant differences in demographic characteristics (age and gender), AVRT/AF inducibility, antegrade conductive properties, the prevalence of multiple APs, and APs locations between IPX and PPX patients.

Conclusions: In our study, patients with IPX did not show significant differences in clinical and electrophysiological features versus PPX patients.

Keywords: Wolff-Parkinson-White syndrome; catheter ablation; intermittent ventricular pre-excitation; sudden death.

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References

REFERENCES

    1. Klein GJ, Gulamhusein SS. Intermittent preexcitation in the Wolff-Parkinson-White syndrome. Am J Cardiol. 1983;52:292-296.
    1. Brembilla-Perrot B, Chometon F, Groben L, et al. Are the results of electrophysiological study different in patients with a pre-excitation syndrome, with and without syncope? Europace. 2008;10:175-180.
    1. Iesaka Y, Yamane T, Takahashi A, et al. Retrograde multiple and multifiber accessory pathway conduction in the Wolff-Parkinson-White syndrome: potential precipitating factor of atrial fibrillation. J Cardiovasc Electrophysiol. 1998;9:141-151.
    1. Montoya PT, Brugada P, Smeets J, et al. Ventricular fibrillation in the Wolff-Parkinson-White syndrome. Eur Heart J. 1991;12:144-150.
    1. Klein GJ, Bashore TM, Sellers TD, Pritchett EL, Smith WM, Gallagher JJ. Ventricular fibrillation in the Wolff-Parkinson-White syndrome. N Engl J Med. 1979;301:1080-1085.

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