ELECTROPHYSIOLOGIC DIFFERENCES IN YOUNG-PATIENTS WITH ATRIAL-FIBRILLATION - INFLUENCE OF PREEXCITATION

Authors
Citation
A. Misra et Gc. Flaker, ELECTROPHYSIOLOGIC DIFFERENCES IN YOUNG-PATIENTS WITH ATRIAL-FIBRILLATION - INFLUENCE OF PREEXCITATION, Journal of electrocardiology, 29(3), 1996, pp. 185-188
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
0022-0736
Volume
29
Issue
3
Year of publication
1996
Pages
185 - 188
Database
ISI
SICI code
0022-0736(1996)29:3<185:EDIYWA>2.0.ZU;2-U
Abstract
Paroxysmal atrial fibrillation is a common arrhythmia, which may occur in young patients without known structural heart disease, with or wit hout preexcitation. Elimination of an accessory pathway in these patie nts may prevent not only orthodromic and antidromic tachycardia but al so atrial fibrillation. However, abnormalities of atrial conduction an d refractoriness have been reported, suggesting that atrial fibrillati on may still recur in these patients. In a review of all electrophysio logic studies performed at the authors' institution since January 1990 in patients under age 60 years of age without identifiable heart dise ase, 24 patients with atrial fibrillation were identified whose electr ophysiologic measurements of a right atrial conduction and effective r efractory period of the right atrium and accessory pathway were in sin us rhythm. Of these patients, 12 had preexcitation and the other 12 di d not. These patients were compared with age- and sex-matched control subjects, 12 with preexcitation without atrial fibrillation and 13 wit hout preexcitation or atrial fibrillation, respectively. Electrophysio logic abnormalities were noted in patients with atrial fibrillation, d epending on the presence or absence of preexcitation. In patients with preexcitation, these abnormalities were a shorter refractory period o f the right atrium (212 +/- 33 ms) and of the accessory pathway (251 /- 27 ms), compared with control subjects (241 +/- 27 ms, P < .05 and 306 +/- 61 ms, P < .02, respectively). In patients without preexcitati on, conduction abnormality in the form of prolonged atrial conduction time when compared with control subjects (48 +/- 26 ms vs 31 +/- 10 ms , P < .05) was noted. These findings may influence the type of antiarr hythmic drug used in these patients, and if confirmed in a larger stud y they may lead to a better understanding of factors influencing the d evelopment of atrial fibrillation in young patients.