Risk of atrial fibrillation according to the initial presentation of a preexcitation syndrome.
BACKGROUND
Atrioventricular reentrant tachycardia (AVRT) is frequent in Wolff-Parkinson-White syndrome (WPW). Atrial fibrillation (AF) is rare. The purpose of the study was to determine the factors of spontaneous AF in WPW according to the initial presentation.


RESULTS
Electrophysiological study (EPS) was performed among 709 patients with a preexcitation syndrome. First event was AF in 44 patients. Remaining patients were studied for AVRT (314), syncope (94), adverse presentation without AF (9) or systematically (248 asymptomatic patients). Patients with AF were older than other patients (44 ± 16 years vs 34.5 ± 17) (0.0003); maximal rate conducted over accessory pathway (AP) was higher in patients with AF than in other patients except in adverse presentation (0.0002); AVRT was induced more frequently in patients with AF than in asymptomatic patients (57% vs 14.5%) but less than in patients with AVRT (89%). AF was induced more frequently in patients with AF than in other patients except in adverse presentation (<0.0001). During follow-up AF occurred more frequently in patients with AF (5; 11%) than in patients with AVRT (7; 2%), with syncope (1%) and asymptomatic patients (4; 1.6%). Older age predicted recurrence (54 ± 16 vs 40 ± 17).


CONCLUSIONS
AF was the first event in only 6% of patients with WPW and was a rare event in other patients. They are older but 10% are less than 18 years and have a more rapid conduction over AP than other patients.
Department of cardiology, University Hospital of Brabois, Vandoeuvre, France. b.brembilla-perrot@chu-nancy.fr
Béatrice
B
Brembilla-Perrot
Irina
I
Popescu
Olivier
O
Huttin
Pierre Yves
PY
Zinzius
Lucian
L
Muresan
Soumaya
S
Jarmouni
Ibrahim
I
Nossier
Jérôme
J
Schwartz
Jean Marc
JM
Sellal
Daniel
D
Beurrier
Marius
M
Andronache
Christian
C
de Chillou
Olivier
O
Selton
Pierre
P
Louis
Arnaud
A
Terrier de la Chaise
D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011226:Pre-Excitation Syndromes / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult