Key result
Adenosine triphosphate (40 mg) abolished anterograde conduction in 10 of 40 patients with evident accessory pathways and prolonged or abolished retrograde conduction in 11 of 53 patients.
Why the study?
Does adenosine triphosphate affect anterograde and retrograde conduction in patients with Wolff-Parkinson-White syndrome?
Observational (n=53)
Does adenosine triphosphate affect anterograde and retrograde conduction in patients with Wolff-Parkinson-White syndrome?
ATP can unexpectedly prolong or abolish conduction in accessory pathways, with the effect dependent on the baseline effective refractory period of the Kent bundle.
May aid EP mapping of ATP-sensitive pathways in WPW; leaves open need for outcome trials before practice change.
To determine the site of the anterograde and retrograde conduction in the Wolff-Parkinson-White syndrome (WPW), 40 mg of adenosine triphosphate (ATP) was injected during electrophysiological studies in 53 patients with ventricular preexcitation. In 40 cases, the accessory pathway was evident (group 1) and in 13 cases it was concealed (group 2). In 10 cases in group 1, anterograde conduction was abolished with disappearance of the features of preexcitation. In 7 patients of group 1 and in 4 patients of group 2, retrograde conduction in the accessory pathway was prolonged or abolished. These effects were unexpected because ATP is a parasympathomimetic drug. There was a correlation between the Kent effective refractory period (ERP) and the action of ATP. When the drug did not change the anterograde and retrograde conduction in the Kent bundle, the anterograde accessory pathway ERP was always less than 230 ms. When ATP only decreased retrograde conduction in the Kent bundle, anterograde accessory pathway ERP was always more than 280 ms.
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Perrot et al. (1984) conducted an observational in Wolff-Parkinson-White syndrome (WPW) with ventricular preexcitation (n=53). Adenosine triphosphate (ATP) was evaluated on Site of anterograde and retrograde conduction in the accessory pathway. Adenosine triphosphate (40 mg) abolished anterograde conduction in 10 of 40 patients with evident accessory pathways and prolonged or abolished retrograde conduction in 11 of 53 patients.
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