© 2002 by European Society of Cardiology
REGULAR ARTICLES
Episodes of atrial fibrillation and atrial vulnerability after successful radiofrequency catheter ablation in patients with WolffParkinsonWhite syndrome
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 |
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Episodes of atrial fibrillation occur in patients with WPW syndrome but frequently disappear after successful radiofrequency ablation.
Key Words: WolffParkinsonWhite syndrome, radiofrequency catheter ablation, atrial fibrillation, atrial vulnerability and follow-up
| Aims |
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To analyze the incidence of atrial fibrillation before and after successful ablation and the presence of increased atrial vulnerability.
| Methods and Results |
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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.
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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.
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