What question did this study set out to answer?

December 1, 1980Circulation

Accessory atrioventricular pathways that conduct only in the antegrade direction.

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Population

143 patients with single accessory pathways, including 7 with exclusive antegrade conduction, 111 with…

Design

Cohort

Authors

SHStephen C. HammillElectrophysiology EPEdward L.C. PritchettElectrophysiology GKGeorge J. KleinElectrophysiology

Discussion

Member takes

Implication

Exclusive antegrade pathways may present later with AF; leaves open distinct sudden-death risk stratification versus bidirectional conduction.

Key Points

To evaluate the clinical presentation and electrophysiological properties of accessory atrioventricular pathways that conduct exclusively in the antegrade direction compared with bidirectional pathways.
Evaluated 143 patients with single accessory pathways classified into exclusive antegrade conduction (n=7), bidirectional conduction (n=111), and exclusive retrograde conduction (n=25).
Compared age, electrophysiological conduction and refractoriness characteristics, and documented arrhythmia presentations between groups.
Patients with exclusive antegrade pathways were significantly older than those with bidirectional pathways (42 ± 9.8 years vs. 31.4 ± 13.9 years, p < 0.0001).
Arrhythmia presentations differed markedly: 6 of 7 exclusive antegrade patients presented solely with atrial fibrillation, whereas bidirectional controls presented with atrioventricular reentrant tachycardia (58/111), atrial fibrillation (23/111), both (19/111), or no documented arrhythmia (11/111).
Antegrade refractoriness and conduction characteristics did not differ qualitatively or quantitatively between the exclusive antegrade and bidirectional control groups.

Structured PICO

Population

143 patients with single accessory pathways, including 7 with exclusive antegrade conduction (study group), 111 with bidirectional conduction (control group), and 25 with exclusive retrograde conduction.

Comparator

Patients with bidirectional conduction (n=111)

Outcome

Clinical presentation (arrhythmias) and electrophysiological characteristics (refractoriness and conduction)

Accessory pathways with exclusive antegrade conduction are a rare variant of WPW syndrome that typically present with atrial fibrillation at an older age compared to bidirectional pathways.

Cite This Study

Hammill et al. (1980) studied this question.

synapsesocial.com/papers/6a820ba40f00bf78d4f219aa https://doi.org/10.1161/01.cir.62.6.1335

Topics

Atrial fibrillation Persistent AF management

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Implication

Exclusive antegrade pathways may present later with AF; leaves open distinct sudden-death risk stratification versus bidirectional conduction.

Accessory atrioventricular pathways that conduct only in the antegrade direction.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Accessory atrioventricular pathways that conduct only in the antegrade direction.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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