Electrophysiology Testing and Catheter Ablation Are Helpful When Evaluating Asymptomatic Patients with Wolff-Parkinson-White Pattern

Skanes, Allan C.; Obeyesekere, Manoj; Klein, George J.

doi:10.1016/j.ccep.2015.05.002

Cited by 12 publications

(9 citation statements)

References 55 publications

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“…The risk of sudden death is related to rapid conduction across the pathway, particularly during AF, if the anterograde refractory period is short. During continuous ambulatory recordings, intermittent preexcitation or sudden loss of preexcitation with sinus rate acceleration is suggestive of "low risk," for example, those that have a shortest pre-excited RR interval during AF .250 ms (Skanes, Obeyesekere, & Klein, 2015). AECG may also be helpful in identifying patients with e68…”

Section: Wolff-parkinson-white Syndromementioning

confidence: 99%

2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry

et al. 2017

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Ambulatory ECG (AECG) is very commonly employed in a variety of clinical contexts to detect cardiac arrhythmias and/or arrhythmia patterns which are not readily obtained from the standard ECG. Accurate and timely characterization of arrhythmias is crucial to direct therapies that can have an important impact on diagnosis, prognosis or patient symptom status. The rhythm information derived from the large variety of AECG recording systems can often lead to appropriate and patient-specific medical and interventional management. The details in this document provide background and framework from which to apply AECG techniques in clinical practice, as well as clinical research.

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Section: Wolff-parkinson-white Syndromementioning

confidence: 99%

2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry

et al. 2017

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“…Male gender, young age, sport, septal accessory pathway (AP), short AP refractory period, and atrial fibrillation (AF) were reported as risk factors of sudden death in PS and WPW syndrome . Catheter ablation essentially eliminates this risk . Electrophysiology (EP) study (EPS) was shown as an effective method to evaluate the risk of sudden death, but the incidence of cases diagnosed as malignant at EPS is higher than the incidence of such spontaneous events.…”

Section: Knowledge Gap Areasmentioning

confidence: 99%

Unresolved questions associated with the management of ventricular preexcitation syndrome

Brembilla‐Perrot

Girerd

Sellal

2018

Pacing Clinical Electrophis

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Many recent recommendations concern the management of preexcitation syndrome. In clinical practice, they are sometimes difficult to use. The purpose of the authors was to discuss the main problems associated with this management. Three problems are encountered: (1) the reality of the absence of symptoms or the interpretation of atypical symptoms, (2) the electrocardiographic diagnosis of preexcitation syndrome that can be missed, and (3) the exact electrophysiological protocol and its interpretation used for the evaluation of the prognosis. Because of significant progress largely related to the development of curative treatment, it seems easy to propose ablation in many patients despite the related risks of invasive studies and to minimize the invasive risk by only performing ablation for patients with at-risk pathways. However, there is a low risk of spontaneous events in truly asymptomatic patients and the indication of accessory pathway ablation should be discussed case by case.

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“…Indications for this procedure are based not only on the tachyarrhythmia-related symptoms and the risk of serious consequences of untreated AP, but they also take into account the risks of the ablation procedure [3,4]. The issue of serious complications of AP ablation is probably the most common reason for the failure to perform this usually curative procedure in asymptomatic or mildly symptomatic patients with overt pre-excitation.…”

Section: Introductionmentioning

confidence: 99%

Contemporary outcomes of catheter ablation of accessory pathways: complications and learning curve

Jastrzębski¹,

Moskal

Pitak

et al. 2017

Kardiol Pol

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A b s t r a c t Background and aim:The aim of this study was to examine contemporary results of accessory pathway (AP) ablation in a sizeable number of patients, focusing on periprocedural complications and the learning curve. Methods:We performed a retrospective cohort study of consecutive AP ablation procedures at three centres by the same operator. In total 629 electrophysiological studies and 610 AP ablation procedures were performed in 570 patients (age: 33 ± 18.9 years).Results: There was one (0.16%) serious and there were 14 (2.3%) minor periprocedural complications. Five hundred and ninety APs were successfully ablated: single/multiple procedure success was 93.4%/96.7%, while the average fluoroscopy time was 13.5 min. There was significantly higher success and less fluoroscopy use with increased experience, while periprocedural complications seemed evenly distributed over the years. The learning was most pronounced for the first 120 cases. However, the learning curve fully flattened only after approximately 400 ablations. Conclusions:This study suggests that in the modern era AP ablation is safer than it was in the first two decades after the introduction of catheter ablation of APs. Perhaps, in experienced centres there should be a lower threshold for referring asymptomatic/mildly symptomatic patients with pre-excitation for electrophysiological study.

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Electrophysiology Testing and Catheter Ablation Are Helpful When Evaluating Asymptomatic Patients with Wolff-Parkinson-White Pattern

Cited by 12 publications

References 55 publications

2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry

2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry

Unresolved questions associated with the management of ventricular preexcitation syndrome

Contemporary outcomes of catheter ablation of accessory pathways: complications and learning curve

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