Key result
Syncope in WPW syndrome is linked to a ~3-fold higher rate of high-risk electrophysiological features.
Why the study?
Syncope in WPW syndrome may indicate arrhythmic events or non-WPW related causes, and the electrophysiological study results according to syncope presence were unclear.
Are electrophysiological study results different in WPW syndrome patients with syncope compared to those without syncope?
Population
518 consecutive patients with WPW syndrome including 71 with syncope
Comparison
Patients with syncope vs asymptomatic or tachycardia patients with WPW syndrome
Design
Observational cohort with transoesophageal electrophysiological study and isoproterenol infusion
Authors
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Syncope in WPW was associated with higher tachycardia inducibility and high-risk forms; leaves open whether EPS is routinely indicated or if non-arrhythmic causes predominate.
Observational (n=518)
Are electrophysiological study results different in WPW syndrome patients with syncope compared to those without syncope?
Absolute Event Rate: 25% vs 8%
p-value: p=<0.001
Patients with WPW syndrome and syncope have a higher incidence of high-risk electrophysiological features compared to asymptomatic patients, suggesting syncope may be a marker for malignant arrhythmias.
Brembilla-Perrot et al. (2008) conducted an observational in Wolff-Parkinson-White (WPW) syndrome (n=518). Syncope vs. Asymptomatic patients was evaluated on Incidence of high-risk form (rapid conduction over accessory pathway and AF or ATD induction) (p=<0.001). Among patients with Wolff-Parkinson-White syndrome, high-risk electrophysiological features were more frequent in those with syncope than in asymptomatic subjects (25% vs 8%, P<0.001).
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