Abstract

VELAZQUEZ-RODRIGUEZ, Enrique; PACHECO-BOUTHILLIER, Alex; RODRIGUEZ-PINA, Horacio  and  DERAS-MEJIA, Luz María. The electrophysiology of Wolff-Parkinson-White in the asymptomatic patient with activity or with high professional risk. Arch. Cardiol. Méx. [online]. 2012, vol.82, n.4, pp.282-289. ISSN 1665-1731.  https://doi.org/10.1016/j.acmx.2012.09.003.

Objective: Describe the electrophysiological characteristics in subjects with asymptomatic Wolff-Parkinson-White with sports activities or high professional responsibility. Methods: Nineteen subjects, mean age 33 ± 13 years (group A). The electrophysiological characteristics were compared with a matched group with symptomatic WPW (group B). Results: At baseline the anterograde refractory period and the anterograde conduction 1:1 over the accessory pathway were longer in group A (300 ± 48 ms vs 262 ± 32 ms, p <0.05 and 355 ± 108 ms vs 307 ± 86 ms, p <0.05), respectively. None of group A had a anterograde refractory period < 250 ms and 58% showed absence of retrograde conduction over the accessory pathway vs 4% of group B (p < 0.001). Induction of tachycardia was significantly less in group A (5%) than in group B (92%) (p < 0.001). Atrial fibrillation was induced in only one of group A vs 32% of group B (p< 0.001). Conclusion: We confirm the benign electrophysiological characteristics in asymptomatic compared to symptomatic subjects. Poor anterograde conduction along with absence of retrograde conduction explains the low frequency of tachyarrhythmias and would not support the routine investigation of all asymptomatic subjects. But, due to possible consequences, remains the systematic indication for preventive ablation in the subgroup of asymptomatic subjects with sporting activities or high professional responsibility.

Keywords : Asymptomatic Wolff-Parkinson-White; Sudden cardiac death; Accessory pathway; Anterograde refractory period; Atrioventricular reciprocating tachycardia; Antidromic atrial fibrillation; Mexico.

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