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


OBJECTIVE
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.


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.
Rosenbaum
M
M
Arrhythmia Service, University of Western Ontario, London.
Klein
G J
GJ
Krahn
A
A
Basta
M
M
Le Feuvre
C
C
Yee
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D017115:Catheter Ablation; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology* / Q000601:surgery*