title: Double atrial potentials recorded in the coronary sinus in patients with Wolff-Parkinson-White syndrome: a possible mechanism of induced atrial fibrillation.
abstract: BACKGROUND
  Double atrial potentials recorded in the coronary sinus are not an unusual phenomenon in patients with supraventricular tachyarrhythmias. They have been demonstrated to potentiate the occurrence of atrial tachyarrhythmias.
  
  
  METHODS
  Two hundred and forty-eight patients were included for investigating the presence of double atrial potentials on the coronary sinus recordings during electrophysiologic study. Group 1 consisted of 136 patients with WPW syndrome and group 2 consisted of 112 patients with atrioventricular nodal reentrant tachycardia (AVNRT). Group 1 patients had a higher incidence of induced atrial fibrillation (AF) (27% vs. 15%, P = 0.045) than group 2 patients. In addition, the incidence of double atrial potentials was significantly higher in group 1 than in group 2 patients (14% vs. 2%, P = 0.001). In group 1, 19 patients with double atrial potentials had a significantly higher incidence of left lateral bypass tracts (79% vs. 39%, P = 0.001) and induced AF (47% vs. 22%, P = 0.01) than 117 patients without double atrial potentials.
  
  
  CONCLUSIONS
  WPW syndrome, especially with a left lateral bypass tract, had a higher incidence of double atrial potentials and induced AF than AVNRT. WPW patients with double atrial potentials had a higher incidence of induced AF than those without double atrial potentials. These findings may contribute to understanding the mechanism of induced AF in WPW syndrome.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Taipei Medical University, School of Medicine, and Taipei Wan-Fang Hospital, Taiwan. td7279@ms25.hinet.net
authors.forename: Ming-Hsiung
authors.initials: MH
authors.lastname: Hsieh
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Tai
authors.forename: Chern-En
authors.initials: CE
authors.lastname: Chiang
authors.forename: Chin-Feng
authors.initials: CF
authors.lastname: Tsai
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Paul
authors.initials: P
authors.lastname: Chan
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Kuo
authors.forename: Shih-Huang
authors.initials: SH
authors.lastname: Lee
authors.forename: Kwo-Chang
authors.initials: KC
authors.lastname: Ueng
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000503:physiopathology* / Q000601:surgery