[Wolf-Parkinson-White syndrome: stratification of syncope risk factors].
OBJECTIVE
To evaluate risk factors of syncopes in patients with Wolf-Parkinson-White syndrome (WPWS) using transesophageal pacing (TEP).


METHODS
82 WPWS patients were divided into two groups: the study group (n = 46) with syncopes and presyncopes, the control group (n = 36) without syncopes. The groups were matched by sex and age. TEP protocol included two stages: before radiofrequency ablation (RFA) and on day 2 after RFA (control test).


RESULTS
Highly significant differences between the groups were detected only in induction of ortodromic tachycardia. In patients of the study group the cycle duration (CD) was 317 +/- 38.9 ms, in the control group - 365.25 +/- 96.3 ms (R = 0.003), heart rate--197.7 +/- 15.03 vs 167.3 +/- 31.65 per 1 min (R = 0.003), heart rate--197.7 +/- 15.03 vs 167.3 +/- 31.65 per 1 min (R = 0.0001), ventricular interval--122.5 +/- 17.5 and 153.1 +/- 44.4 ms (R = 0.0001). A correlation was found between syncope risk and baseline heart rate, CD, Venkebach point, antegrade effective refractory period of additional atrioventricular connection, ventriculoatrial interval during tachycardia, WPWS manifestation, atrial fibrillation, arrhythmia history.


CONCLUSIONS
The detected electrophysiological changes allow early detection of patients at high syncope risk among WPWS patients and reduction of sudden cardiac death risk in these patients.
Abdrakhmanov
A S
AS
D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology; D016022:Case-Control Studies; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D012307:Risk Factors; D013575:Syncope / Q000209:etiology* / Q000503:physiopathology; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications* / Q000503:physiopathology