Influence of reciprocating tachycardia on the development of atrial fibrillation in patients with preexcitation syndrome.
BACKGROUND
We sought to evaluate the influence of atrio-ventricular reentrant tachycardia (AVRT) on atrial pressures during tachycardia and the presence of atrial fibrillation (AF) in patients with preexcitation syndrome.


METHODS
The study population consisted of 88 patients (37 females, mean age 37.3 years) with left-sided accessory pathway and AVRT induced during electrophysiologic study. The AF-inducible group consisted of 32 patients with sustained episodes of AF provoked during electrophysiologic study, whereas the noninducible group comprised 56 patients without AF.


RESULTS
We found significantly higher values of maximal and mean left (LAP) and right (RAP) atrial pressures in the AF group compared with noninducible group: LAP max 32.0 versus 20.8, LAP mean 21.6 versus 13.2, RAP max 15.2 versus 11.5, RAP mean 8.2 versus 6.2 respectively (P < 0.001). When analyzing the effect of AVRT on atrial pressures, we found a significant (P < 0.001) negative correlation between anterograde conduction times during tachycardia and LAP max and LAP mean in the whole population, but a significant positive correlation between retrograde conduction time and left atrial pressures. Similar effects of AVRT on the right atrial pressures were found.


CONCLUSIONS
Atrial pressures during AVRT, which depend on the electrophysiological features of tachycardia, play an important role in the genesis of atrial fibrillation in patients with preexcitation syndrome.
Kalarus
Zbigniew
Z
1st Department of Cardiology, Silesian School of Medicine, Silesian Center of Heart Diseases, Zabrze, Poland. elfizab@poczta.onet.pl
Lenarczyk
Radosław
R
Kowalski
Oskar
O
Pruszkowska-Skrzep
Patrycja
P
Krupa
Hubert
H
Sredniawa
Beata
B
Sokal
Adam
A
Zielińska
Teresa
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology*; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011226:Pre-Excitation Syndromes / Q000150:complications*; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications*; D013614:Tachycardia, Paroxysmal / Q000150:complications*