What question did this study set out to answer?

To determine whether intrinsic atrioventricular nodal conduction properties dictate the manifestation of ventricular preexcitation over an accessory pathway in Wolff–Parkinson–White syndrome.

September 24, 2001Clinical Physiology

Atrioventricular conduction: a determinant for the manifestation of ventricular preexcitation in patients with Wolff–Parkinson–White syndrome

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Why the study?

Are atrioventricular nodal conduction properties associated with the manifestation of ventricular preexcitation in patients with Wolff-Parkinson-White syndrome?

Key Points

To determine whether intrinsic atrioventricular nodal conduction properties dictate the manifestation of ventricular preexcitation over an accessory pathway in Wolff–Parkinson–White syndrome.
Assessed electrophysiological properties in 285 patients with manifest preexcitation and 204 patients with concealed accessory pathways undergoing radiofrequency ablation alongside 146 control subjects.
Measured post-ablation atrioventricular block incidence, atrial-His intervals, PR intervals, and ventriculoatrial dissociation across cohorts.
Post-ablation first- or second-degree atrioventricular block occurred in 13 (5%) patients with preexcitation, compared with 0% in concealed pathway (P=0.001) and control cohorts (P=0.006).
Patients with manifest preexcitation exhibited significantly longer atrial-His intervals (88 ± 20 ms) than concealed pathway (76 ± 15 ms, P<0.0001) and control patients (77 ± 15 ms, P=0.0007).
PR intervals remained prolonged in manifest preexcitation (165 ± 25 ms) compared to concealed (149 ± 20 ms) and control cohorts (150 ± 21 ms, P<0.0001), with ventriculoatrial dissociation occurring more frequently in preexcitation.

Structured PICO

Are atrioventricular nodal conduction properties associated with the manifestation of ventricular preexcitation in patients with Wolff-Parkinson-White syndrome?

Population

635 patients, comprising 285 with manifest accessory pathway (preexcitation) and 204 with concealed accessory pathway who underwent radiofrequency ablation, along with 146 controls.

Intervention

Electrophysiological evaluation and radiofrequency ablation

Comparator

Patients with concealed accessory pathway and control patients

Outcome

Atrioventricular nodal characteristics including incidence of atrioventricular block, atrial-His intervals, and PR intervalssurrogate

A relatively long atrioventricular conduction time is an electrophysiological prerequisite for the manifestation of preexcitation in Wolff-Parkinson-White syndrome.

Discussion

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Implication

Longer AH intervals associate with preexcitation manifestation; supports AV nodal prerequisite in WPW but leaves causal mechanisms open.

Cite This Study

Liu et al. (2001) studied this question.

synapsesocial.com/papers/6a71ef4222b3175134db6ad5 https://doi.org/10.1046/j.1365-2281.2001.00347.x

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Atrioventricular conduction: a determinant for the manifestation of ventricular preexcitation in patients with Wolff–Parkinson–White syndrome

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Atrioventricular conduction: a determinant for the manifestation of ventricular preexcitation in patients with Wolff–Parkinson–White syndrome

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider