title: Incidence and prognostic significance of spontaneous and inducible antidromic tachycardia.
abstract: OBJECTIVE
  Orthodromic atrioventricular reentrant tachycardia (ORT) is the most common arrhythmia at electrophysiological study (EPS) in patients with pre-excitation. The purpose of the study was to determine the clinical significance and the electrophysiological characteristics of patients with inducible antidromic tachycardia (ADT).
  
  
  RESULTS
  Electrophysiological study was performed in 807 patients with a pre-excitation syndrome in control state and after isoproterenol. Antidromic tachycardia was induced in 63 patients (8%). Clinical and electrophysiological data were compared with those of 744 patients without ADT. Patients with and without ADT were similar in term of age (33 ± 18 vs. 34 ± 17), male gender (68 vs. 61%), clinical presentation with spontaneous atrioventricular reentrant tachycardia (AVRT) (35 vs. 42%), atrial fibrillation (AF) (3 vs. 3%), syncope (16 vs. 12%). In patients with induced ADT, asymptomatic patients were less frequent (24 vs. 37%; <0.04), spontaneous ADT and spontaneous malignant form more frequent (8 vs. 0.5%; <0.001) (16 vs. 6%; <0.002). Left lateral accessory pathway (AP) location was more frequent (51 vs. 36%; P < 0.022), septal location less frequent (40 vs. 56%; P < 0.01). And 1/1 conduction through AP was more rapid. Orthodromic AVRT induction was as frequent (55.5 vs. 55%), but AF induction (41 vs. 24%; P < 0.002) and electrophysiological malignant form were more frequent (22 vs. 12%; P < 0.02). The follow-up was similar; four deaths and three spontaneous malignant forms occurred in patients without ADT. When population was divided based on age (<20/≥20 years), the older group was less likely to have criteria for malignant form.
  
  
  CONCLUSIONS
  Antidromic tachycardia induction is rare in pre-excitation syndrome and generally is associated with spontaneous or electrophysiological malignant form, but clinical outcome does not differ.
authors.affiliation: Department of cardiology, University Hospital of Brabois, 54500 Vandoeuvre, Les Nancy, France. b.brembilla-perrot@chu-nancy.fr
authors.forename: Béatrice
authors.initials: B
authors.lastname: Brembilla-Perrot
authors.forename: Maheshwar
authors.initials: M
authors.lastname: Pauriah
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Sellal
authors.forename: Pierre Yves
authors.initials: PY
authors.lastname: Zinzius
authors.forename: Jérôme
authors.initials: J
authors.lastname: Schwartz
authors.forename: Christian
authors.initials: C
authors.lastname: de Chillou
authors.forename: Gabriel
authors.initials: G
authors.lastname: Cismaru
authors.forename: Daniel
authors.initials: D
authors.lastname: Beurrier
authors.forename: Damien
authors.initials: D
authors.lastname: Voilliot
authors.forename: Olivier
authors.initials: O
authors.lastname: Selton
authors.forename: Pierre
authors.initials: P
authors.lastname: Louis
authors.forename: Marius
authors.initials: M
authors.lastname: Andronache
authors.forename: Radu
authors.initials: R
authors.lastname: Nosu
authors.forename: Arnaud Terrier
authors.initials: AT
authors.lastname: de la Chaise
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004562:Electrocardiography / Q000706:statistics & numerical data*; D022062:Electrophysiologic Techniques, Cardiac / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011226:Pre-Excitation Syndromes / Q000175:diagnosis* / Q000453:epidemiology*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D063507:Sexism; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult