Key result
Wolff-Parkinson-White syndrome was associated with significantly increased maximum left atrial volume compared to controls (40 vs 34 mL/m2, p=0.022) and altered strain rates, indicating increased atrial vulnerability.
Why the study?
Does radiofrequency catheter ablation improve atrial function and reduce atrial vulnerability (assessed by 2D-STE) in patients with Wolff-Parkinson-White syndrome compared to patients with DAVNP?
Case-Control (n=52)
Single-blind
No
Does radiofrequency catheter ablation improve atrial function and reduce atrial vulnerability (assessed by 2D-STE) in patients with Wolff-Parkinson-White syndrome compared to patients with DAVNP?
Radiofrequency catheter ablation of the accessory pathway in Wolff-Parkinson-White syndrome improves atrial function and reduces atrial vulnerability as assessed by two-dimensional speckle tracking echocardiography.
WPW-associated atrial enlargement may signal vulnerability; leaves open whether ablation reverses these changes.
PURPOSE: The aim was to assess atrial fibrillation (AF) and vulnerability in Wolff-Parkinson-White (WPW) syndrome patients using two-dimensional speckle tracking echocardiography (2D-STE). METHODS: All patients were examined via transthoracic echocardiography and 2D-STE in order to assess atrial function 7 days before and 10 days after RF catheter ablation. A postoperative 3-month follow-up was performed via outpatient visit or telephone calls. RESULTS: Results showed significant differences in both body mass index (BMI) and supraventricular tachycardia (SVT) duration between WPW patients and DAVNP patients (both P<0.05). Echocardiography revealed that the maximum left atrial volume (LAVmax) and the left ventricular mass index (LVMI) in diastole increased noticeably in patients with WPW compared to patients with DAVNP both before and after ablation (all P<0.05). Before ablation, there were obvious differences in the levels of SRs, SRe, and SRa from the 4-chamber view (LA) in the WPW patients group compared with patients in the DAVNP group (all P<0.05). In the AF group, there were significant differences in the levels of systolic strain rate (SRs), early diastolic strain rate (SRe), and late diastolic strain rate (SRa) from the 4-chamber view (LA) both before and after ablation (all P<0.05). In the non-AF group, there were decreased SRe levels from the 4-chamber view (LA/RA) pre-ablation compared to post-ablation (all P<0.05). CONCLUSION: Our findings provide convincing evidence that WPW syndrome may result in increased atrial vulnerability and contribute to the development of AF. Further, RF catheter ablation of AAV pathway can potentially improve atrial function in WPW syndrome patients. Two-dimensional speckle tracking echocardiography imaging in WPW patients would be necessary in the evaluation and improvement of the overall function of RF catheter ablation in a long-term follow-up period.
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Li et al. (2014) conducted a case-control in Wolff-Parkinson-White Syndrome (n=52). Wolff-Parkinson-White syndrome vs. Dual atrioventricular nodal pathways (DAVNP) was evaluated on Maximum left atrial volume (LAV max) before ablation (p=0.022). Wolff-Parkinson-White syndrome was associated with significantly increased maximum left atrial volume compared to controls (40 vs 34 mL/m2, p=0.022) and altered strain rates, indicating increased atrial vulnerability.
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