title: Age-related prognosis of syncope associated with a preexcitation syndrome.
abstract: BACKGROUND
  Syncope in Wolff-Parkinson-White syndrome (WPW) is without relationship with WPW or reveals a poorly tolerated arrhythmia. Electrophysiologic study (EPS) is recommended. The purpose of the study was to evaluate the influence of the patient's age on the causes and prognosis of syncope.
  
  
  METHODS
  A total of 98 patients, mean age 35 ± 18 years, with WPW were admitted for syncope. Note that 29 were aged between 9 and 19 years (mean 15 ± 3) (children and teenagers/group I), 45 between 20 and 49 years (mean 34 ± 8) (adults/group II), and 24 between 50 and 70 years (mean 60 ± 8) (elderly/group III). EPS consisted of atrial pacing and programmed atrial stimulation in control state and after isoproterenol.
  
  
  RESULTS
  Potentially malignant form (rapid conduction in accessory pathway >240 beats/min in control state or >300 beats/min after isoproterenol and atrial fibrillation [AF] induction) was more frequent in group I (34%) than in groups II (7%) (P < 0.002) and III (0%) (P < 0.001). Orthodromic atrioventricular reentrant tachycardia (AVRT) and AF were induced as frequently in groups I (59, 34%), II (47, 15.5%), and III (54, 17%). AVRT was induced in all but one patient with malignant form. EPS was as frequently negative in groups I (27.5%), II (44%), and III (37.5%). Natural follow-up (mean 8 ± 6 years) indicated a favorable prognosis, only related to AVRT induction. Induced AF was without significance.
  
  
  CONCLUSIONS
  Data in syncope and WPW syndrome depended on age: electrophysiological malignant form was frequent in children/teenagers, rare in adults, and absent in elderly. AVRT, the main cause of syncope, was as frequent in all ranges of age. AF's induction alone had no significance. Final prognosis was favorable.
authors: Department of Cardiology, CHU of Brabois, Vandoeuvre, France. b.brembillaperrot@chu-nancy.fr
authors: Béatrice
authors: B
authors: Brembilla-Perrot
authors: Anne M
authors: AM
authors: Zinsch
authors: Jean M
authors: JM
authors: Sellal
authors: Pierre Y
authors: PY
authors: Zinzius
authors: Jérôme
authors: J
authors: Schwartz
authors: Daniel
authors: D
authors: Beurrier
authors: Christian
authors: C
authors: DE Chillou
authors: Jean P
authors: JP
authors: Godenir
authors: Jean P
authors: JP
authors: Lethor
authors: Cécile
authors: C
authors: Marchal
authors: Jean L
authors: JL
authors: Cloez
authors: Maheshwar
authors: M
authors: Pauriah
authors: Radu
authors: R
authors: Nosu
authors: Marius
authors: M
authors: Andronache
authors: François
authors: F
authors: Marçon
mesh_terms: D000328:Adult; D017677:Age Distribution; D015984:Causality; D015897:Comorbidity; D022062:Electrophysiologic Techniques, Cardiac / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D013575:Syncope / Q000175:diagnosis* / Q000453:epidemiology*; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis* / Q000453:epidemiology*
keywords: Wolff-Parkinson-White syndrome; age; electrophysiological study; syncope