Skip Navigation

Europace 2002 4(2):201-206; doi:10.1053/eupc.2002.0223
© 2002 by European Society of Cardiology
This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (4)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Oddsson, H.
Right arrow Articles by Walfridsson, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Oddsson, H.
Right arrow Articles by Walfridsson, H.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


REGULAR ARTICLES

Episodes of atrial fibrillation and atrial vulnerability after successful radiofrequency catheter ablation in patients with Wolff–Parkinson–White syndrome

H. Oddsson1, N. Edvardsson and H. Walfridsson

Divisions of Cardiology, Örebro University Hospital and Sahlgrenska University Hospital Göteborg, Sweden; 1Örebro University Hospital and Sahlgrenska University Hospital Göteborg, Sweden

Manuscript submitted 28 November 2000. Accepted after revision 10 January 2002.

Correspondence: Hjörtur Oddsson, Department of Cardiology, Örebro University Hospital, S-701 85 Örebro, Sweden. E-mail: Hjortur.Oddsson{at}orebroll.se


    Abstract
 Top
 Abstract
 Aims
 Methods and Results
 Conclusions
 References
 
Episodes of atrial fibrillation occur in patients with WPW syndrome but frequently disappear after successful radiofrequency ablation.

Key Words: Wolff–Parkinson–White syndrome, radiofrequency catheter ablation, atrial fibrillation, atrial vulnerability and follow-up


    Aims
 Top
 Abstract
 Aims
 Methods and Results
 Conclusions
 References
 
To analyze the incidence of atrial fibrillation before and after successful ablation and the presence of increased atrial vulnerability.


    Methods and Results
 Top
 Abstract
 Aims
 Methods and Results
 Conclusions
 References
 
Fifty-four of 183 WPW patients had at least one documented episode of atrial fibrillation before ablation. During a follow-up of 24±12 months 13/54 patients (24%) experienced atrial fibrillation. At baseline, the patients with atrial fibrillation were more often men (74% vs 53%, P=0·007), were older (45±15 vs 34±16 years, P=0·0001), more often had pre-excitation during sinus rhythm (87% vs, 73%,P =0·04) and had increased atrial vulnerability (41% vs 18%, P< 0·001). Only patients with atrial fibrillation before, developed atrial fibrillation after ablation. The 13 (of 54) patients who relapsed were also older (53±13 vs 42±15 years, P=0·03), had increased atrial vulnerability at baseline (77% vs 29%, P=0·002), and were more symptomatic, (13±21 vs 1±3 arrhythmia attacks/month, P=0·001). No patient without atrial fibrillation before ablation developed atrial fibrillation after treatment.


    Conclusions
 Top
 Abstract
 Aims
 Methods and Results
 Conclusions
 References
 
The accessory pathway was important for the development of atrial fibrillation. Frequent tachycardias seem to promote an electrical remodelling and an increased atrial vulnerability to atrial fibrillation, whereas after successful ablation the majority of patients remain free of atrial fibrillation. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.


    References
 Top
 Abstract
 Aims
 Methods and Results
 Conclusions
 References
 
[1] Montoya PT, Brugada P, Smeets J, et al. Ventricular fibrillation in the Wolff–Parkinson–White syndrome. Eur Heart J 1991; 12: 144–150.[Abstract/Free Full Text]

[2] Klein GJ, Bashore TM, Sellers TD, Pritchett EL, Smith WM, Gallagher JJ. Ventricular fibrillation in the Wolff–Parkinson–White syndrome. N Engl J Med 1979; 301: 1080–1085.[Abstract]

[3] Attoyan C, Haïsaguerre M, Dartigues JF, Le Metayer P, Warin JF, Clementy J. Ventricular fibrillation in Wolff–Parkinson–White syndrome. Predictive factors. Arch Mal Coeur Vaiss 1994; 87: 889–897.[Web of Science][Medline]

[4] Calkins H, Langberg J, Sousa J, et al. Radiofrequency catheter ablation of accessory atrioventricular connections in 250 patients. Abbreviated therapeutic approach to Wolff–Parkinson–White syndrome. Circulation 1992; 85: 1337–1346.[Abstract/Free Full Text]

[5] Kuck K, Schluter M, Geiger M, Siebels J, Duckeck W. Radiofrequency current catheter ablation of accessory atrioventricular pathways. Lancet 1991; 1557–1561.

[6] Jackman W, Wang X, Friday K, Roman C, Moulton K, Beckman K. Catheter ablation of accessory atrioventricular pathways (Wolff–Parkinson–White syndrome) by radiofrequency current. N Eng J Med 1991; 324: 1605–1611.[Abstract]

[7] Fujimura O, Klein GJ, Yee R, Sharma AD. Mode of onset of atrial fibrillation in the Wolff–Parkinson–White syndrome: how important is the accessory pathway? J Am Coll Cardiol 1990; 15: 1082–1086.[Abstract]

[8] Kalbfleisch SJ, el-Atassi R, Calkins H, Langberg JJ, Morady F. Inducibility of atrial fibrillation before and after radiofrequency catheter ablation of accessory atrioventricular connections. J Cardiovasc Electrophysiol 1993; 4: 499–503.[Web of Science][Medline]

[9] Wathen M, Natale A, Wolfe K, Yee R, Klein G. Initiation of atrial fibrillation in the Wolff–Parkinson–White syndrome: the importance of the accessory pathway. Am Heart J 1993; 125: 753–759.[CrossRef][Web of Science][Medline]

[10] Tai C, Chen S, Chiang C, et al. Accessory atrioventricular pathways with only antegrade conduction in patients with symptomatic Wolff–Parkinson–White syndrome. Clinical features, electrophysiological characteristics and response to radiofrequency catheter ablation. Eur Heart J 1997; 18: 132–139.[Abstract/Free Full Text]

[11] Fischell TA, Stinson EB, Derby GC, Swerdlow CD. Long-term follow-up after surgical correction of Wolff–Parkinson–White syndrome. J Am Coll Cardiol 1987; 9: 283–287.[Abstract]

[12] Chen PS, Pressley JC, Tang AS, Packer DL, Gallagher JJ, Prystowsky EN. New observations on atrial fibrillation before and after surgical treatment in patients with the Wolff–Parkinson–White syndrome. J Am Coll Cardiol 1992; 19: 974–981.[Abstract]

[13] Haïssaguerre M, Fischer B, Labbe T, et al. Frequency of recurrent atrial fibrillation after catheter ablation of overt accessory pathways. Am J Cardiol 1992; 69: 493–497.[CrossRef][Web of Science][Medline]

[14] Sharma AD, Klein GJ, Guiraudon GM, Milstein S. Atrial fibrillation in patients with Wolff–Parkinson–White syndrome: incidence after surgical ablation of the accessory pathway. Circulation 1985; 72: 161–169.[Abstract/Free Full Text]

[15] Della Bella P, Brugada P, Talajic M, et al. Atrial fibrillation in patients with an accessory pathway: importance of the conduction properties of the accessory pathway. J Am Coll Cardiol 1991; 17: 1352–1356.[Abstract]

[16] Kannel WB, Abbott RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med 1982; 306: 1018–1022.[Abstract]

[17] Konoe A, Fukatani M, Tanigawa M, et al. Electrophysiological abnormalities of the atrial muscle in patients with manifest Wolff–Parkinson–White syndrome associated with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 1992; 15: 1040–1052.[CrossRef][Medline]

[18] Fan W, Peter CT, Gang ES, Mandel W. Age-related changes in the clinical and electrophysiologic characteristics of patients with Wolff–Parkinson–White syndrome: comparative study between young and elderly patients. Am Heart J 1991; 122: 741–747.[CrossRef][Web of Science][Medline]

[19] Asano Y, Kaneko K, Matsumoto K, Saito J, Yamamoto T, Dohi Y. Atrial fibrillation and atrial vulnerability in the Wolff–Parkinson–White syndrome. Jpn Circ J 1991; 55: 287–296.[Medline]

[20] Tsuchioka Y, Karakawa S, Nagata K, et al. The role of the accessory pathway in the onset of atrial fibrillation in Wolff–Parkinson–White syndrome — electrophysiological examination before and after surgical ablation. Jpn Circ J 1994; 58: 95–99.[Medline]

[21] Muraoka Y, Karakawa S, Yamagata T, Matsuura H, Kajiyama G. Dependency on atrial electrophysiological properties of appearance of paroxysmal atrial fibrillation in patients with Wolff–Parkinson–White syndrome: evidence from atrial vulnerability before and after radiofrequency catheter ablation and surgical cryoablation. Pacing Clin Electrophysiol 1998; 21: 438–446.[CrossRef][Medline]


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (4)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Oddsson, H.
Right arrow Articles by Walfridsson, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Oddsson, H.
Right arrow Articles by Walfridsson, H.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?