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Utility of full electrophysiological study before accessory pathway ablation in Wolff-Parkinson-White syndrome.

AbstractBACKGROUND:
A single catheter technique has been described for ablation in patients with Wolff-Parkinson-White syndrome. It is unknown how often omission of a standard electrophysiological study would lead to misdiagnosis based on an assumption that the manifest accessory pathway is responsible for clinical tachycardia.
OBJECTIVES:
To examine the contribution of the standard electrophysiological study versus an abbreviated, single catheter approach in patients with Wolff-Parkinson-White syndrome and an overt delta wave electrocardiographically.
PATIENTS AND METHODS:
One hundred and fifty consecutive patients with a delta wave present on electrocardiogram referred for ablation had prior full diagnostic electrophysiological study.
RESULTS:
In 83% (124 of 150) of patients, the index accessory pathway was responsible for tachycardia and single catheter ablation would suffice. In 11% (17 of 150) of patients, the index pathway was not found to be the culprit producing tachycardia and in another 6% (nine of 150) additional information was obtained from electrophysiological study with possible clinical significance.
CONCLUSIONS:
Omission of the full diagnostic electrophysiological study is acceptable in the majority of patients presenting with a delta wave on electrocardiogram. However, important clinical information is missed in a sizeable minority of patients.
AuthorsM Rosenbaum, G J Klein, A Krahn, M Basta, C Le Feuvre, R Yee
JournalThe Canadian journal of cardiology (Can J Cardiol) Vol. 13 Issue 4 Pg. 359-62 (Apr 1997) ISSN: 0828-282X [Print] England
PMID9141967 (Publication Type: Journal Article)
Topics
  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Catheter Ablation
  • Electrocardiography
  • Electrophysiology
  • Female
  • Heart Conduction System (physiopathology, surgery)
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Wolff-Parkinson-White Syndrome (physiopathology, surgery)

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