title: Are the results of electrophysiological study different in patients with a pre-excitation syndrome, with and without syncope?
abstract: OBJECTIVE
  Syncope in Wolff-Parkinson-White (WPW) syndrome may reveal an arrhythmic event or is not WPW syndrome related. The aim of the study is to evaluate the results of electrophysiological study in WPW syndrome according to the presence or not of syncope and the possible causes of syncope.
  
  
  RESULTS
  Among 518 consecutive patients with diagnosis of WPW syndrome, 71 patients, mean age 34.5 +/- 17, presented syncope. Transoesophageal electrophysiological study in control state and after isoproterenol infusion was performed in the out-patient clinic. Atrioventricular re-entrant tachycardia (AVRT) was more frequently induced than in asymptomatic patients (n = 38, 53.5%, P < 0.01), less frequently than in those with tachycardia; atrial fibrillation (AF) and/or antidromic tachycardia (ATD) was induced in 28 patients (39%) more frequently (P < 0.05) than in asymptomatic patients or those with tachycardia. The incidence of high-risk form [rapid conduction over accessory pathway (AP) and AF or ATD induction] was higher in syncope group (n = 18, 25%, P < 0.001) than in asymptomatic subjects (8%) or those with tachycardias (7.5%). Maximal rate conducted over AP was similar in patients with and without syncope, and higher in patients with spontaneous AF, but without syncope. Results were not age-related.
  
  
  CONCLUSIONS
  Tachycardia inducibility was higher in patients with syncope than in the asymptomatic group. The incidence of malignant WPW syndrome was higher in patients with syncope than in asymptomatic or symptomatic population, but the maximal rate conducted over AP was not higher and another mechanism could be also implicated in the mechanism of syncope.
authors.affiliation: Department of Cardiology, CHU of Brabois, 54500 Vandoeuvre, France. b.brembilla-perrot@chu-nancy.fr
authors.forename: Béatrice
authors.initials: B
authors.lastname: Brembilla-Perrot
authors.forename: Frédéric
authors.initials: F
authors.lastname: Chometon
authors.forename: Laurent
authors.initials: L
authors.lastname: Groben
authors.forename: Charif
authors.initials: C
authors.lastname: Tatar
authors.forename: Jean-Dominique
authors.initials: JD
authors.lastname: Luporsi
authors.forename: Julien
authors.initials: J
authors.lastname: Bertrand
authors.forename: Olivier
authors.initials: O
authors.lastname: Huttin
authors.forename: Daniel
authors.initials: D
authors.lastname: Beurrier
authors.forename: Sonia
authors.initials: S
authors.lastname: Ammar
authors.forename: Juanico
authors.initials: J
authors.lastname: Cedano
authors.forename: Nacima
authors.initials: N
authors.lastname: Benzaghou
authors.forename: Marius
authors.initials: M
authors.lastname: Andronache
authors.forename: Rouzbeh
authors.initials: R
authors.lastname: Valizadeh
authors.forename: Arnaud
authors.initials: A
authors.lastname: Terrier De La Chaise
authors.forename: Pierre
authors.initials: P
authors.lastname: Louis
authors.forename: Olivier
authors.initials: O
authors.lastname: Selton
authors.forename: Olivier
authors.initials: O
authors.lastname: Claudon
authors.forename: François
authors.initials: F
authors.lastname: Marçon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000453:epidemiology* / Q000503:physiopathology*; D013610:Tachycardia / Q000150:complications / Q000503:physiopathology; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications* / Q000503:physiopathology*