Are the results of electrophysiological study different in patients with a pre-excitation syndrome, with and without syncope?
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.
Brembilla-Perrot
Béatrice
B
Department of Cardiology, CHU of Brabois, 54500 Vandoeuvre, France. b.brembilla-perrot@chu-nancy.fr
Chometon
Frédéric
F
Groben
Laurent
L
Tatar
Charif
C
Luporsi
Jean-Dominique
JD
Bertrand
Julien
J
Huttin
Olivier
O
Beurrier
Daniel
D
Ammar
Sonia
S
Cedano
Juanico
J
Benzaghou
Nacima
N
Andronache
Marius
M
Valizadeh
Rouzbeh
R
Terrier De La Chaise
Arnaud
A
Louis
Pierre
P
Selton
Olivier
O
Claudon
Olivier
O
Marçon
François
F
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*