Double atrial potentials recorded in the coronary sinus in patients with Wolff-Parkinson-White syndrome: a possible mechanism of induced atrial fibrillation.
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.
Hsieh
Ming-Hsiung
MH
Division of Cardiovascular Medicine, Department of Medicine, Taipei Medical University, School of Medicine, and Taipei Wan-Fang Hospital, Taiwan. td7279@ms25.hinet.net
Tai
Ching-Tai
CT
Chiang
Chern-En
CE
Tsai
Chin-Feng
CF
Chen
Yi-Jen
YJ
Chan
Paul
P
Kuo
Yu-Chen
YC
Lee
Shih-Huang
SH
Ueng
Kwo-Chang
KC
Chen
Shih-Ann
SA
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