[Significance of tachycardia induced by atrial stimulation in Wolff-Parkinson-White syndrome].
Increased atrial vulnerability is one of the criteria of malignant Wolff-Parkinson-White syndrome. The aim of this study was to try to define the methods of induction of atrial tachycardias (tachycardia, flutter, fibrillation) by endocavitary and oesophageal stimulation characterising an increased vulnerability. The incidence of induced sustained tachycardia by fixed atrial stimulation at incremental rates until the Wenckebach point is attained and programmed atrial stimulation using 1 and 2 extrastimuli under basal conditions and then with isoproterenol was compared in subjects without cardiac disease, Wolff-Parkinson-White or spontaneous tachycardia (Group I) and patients with Wolff-Parkinson-White and spontaneous tachycardias (Group II). Atrial stimulation only induced tachycardia in 2.5% of normal subjects under basal conditions or with isoproterenol, by the endocavitary or oesophageal approaches. Programmed stimulation induced tachycardia in 15% of normal subjects under basal conditions or with isoproterenol by the endocavitary approach alone. In Group II, tachycardia was reproduced under basal conditions or with isoproterenol by atrial stimulation or programmed stimulation in all patients. In conclusion, the induction of a tachyarrhythmia by incremental atrial stimulation up to the Wenckebach point is always pathological even with isoproterenol. Programmed atrial stimulation is less specific except by the oesophageal approach. The use of bursts of very rapid stimuli in the Wolff-Parkinson-White syndrome is of no value as tachycardia can be induced by classical methods in all subjects at risk.
Brembilla-Perrot
B
B
Service de cardiologie A-B, CHU de Brabois, Vandoeuvre.
D001281:Atrial Fibrillation / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D006325:Heart Atria; D006801:Humans; D007545:Isoproterenol; D013610:Tachycardia / Q000209:etiology / Q000503:physiopathology*; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology*
D007545:Isoproterenol
Signification du déclenchement des tachycardies par stimulation auriculaire dans le syndrome de Wolff-Parkinson-White.