Abstract
BackgroundParoxysmal atrial fibrillation (AF) frequently occurs in patients with Wolff‐Parkinson‐White (WPW) syndrome. Although successful ablation of the accessory pathway (AP) eliminates paroxysmal AF in some patients, in other patients it can recur.HypothesisWe investigated the clinical utility of advanced interatrial block (IAB) for predicting the risk of AF recurrence in patients with verified paroxysmal AF and WPW syndrome after successful AP ablation.MethodsThis retrospective study included 103 patients (70 men, 33 women; mean age, 44 ± 16 years) with WPW syndrome who had paroxysmal AF. A resting 12‐lead electrocardiogram was performed immediately after successful AP ablation to evaluate the presence of advanced IAB, which was defined as a P‐wave duration of >120 ms and biphasic [±] morphology in the inferior leads.ResultsDuring the mean follow‐up period of 30.9 ± 20.0 months (range, 2‐71 months), 16 patients (15.5%) developed AF recurrence. Patients with advanced IAB had significantly reduced event‐free survival from AF (P < .001). Cox regression analysis with adjustment for the left atrial diameter and CHA2DS2‐VASc score identified advanced IAB (hazard ratio, 9.18; 95% confidence interval [CI], 2.30‐36.72; P = .002) and age > 50 years (hazard ratio, 12.64; 95% CI, 1.33‐119.75; P = .027) as independent predictors of AF recurrence.ConclusionsAdvanced IAB was an independent predictor of AF recurrence after successful AP ablation in patients with WPW syndrome.
Highlights
Paroxysmal atrial fibrillation (AF) occurs frequently in patients with Wolff-Parkinson-White (WPW) syndrome, with a reported incidence of 9% to 38%.1-4 Previous studies have reported a decreased incidence in AF after successful elimination of the accessory pathway (AP),[5,6] indicating that the AP itself may play an important role in the initiation of AF
In the present study, we investigated the clinical utility of advanced interatrial block (IAB) for predicting the risk of AF recurrence in patients with verified paroxysmal AF and WPW syndrome after successful AP ablation
Cox regression analysis with adjustment for the CHA2DS2-VASc score and left atrial diameter identified advanced IAB and age > 50 years as independent predictors of AF recurrence (Table 3)
Summary
Paroxysmal atrial fibrillation (AF) occurs frequently in patients with Wolff-Parkinson-White (WPW) syndrome, with a reported incidence of 9% to 38%.1-4 Previous studies have reported a decreased incidence in AF after successful elimination of the accessory pathway (AP),[5,6] indicating that the AP itself may play an important role in the initiation of AF. Paroxysmal atrial fibrillation (AF) occurs frequently in patients with Wolff-Parkinson-White (WPW) syndrome, with a reported incidence of 9% to 38%.1-4. Previous studies have reported a decreased incidence in AF after successful elimination of the accessory pathway (AP),[5,6] indicating that the AP itself may play an important role in the initiation of AF. Paroxysmal AF still frequently recurs in some patients with WPW syndrome despite successful AP elimination.[3,4,7-9]. The role of advanced IAB in predicting the recurrence of AF after AP ablation in patients with WPW syndrome is unclear. In the present study, we investigated the clinical utility of advanced IAB for predicting the risk of AF recurrence in patients with verified paroxysmal AF and WPW syndrome after successful AP ablation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
