Age-Related Prognosis of Syncope Associated with a Preexcitation Syndrome

Autor:	Radu Nosu, Cécile Marchal, Marius Andronache, Jean P. Godenir, François Marçon, Béatrice Brembilla-Perrot, Anne M. Zinsch, Jean Marc Sellal, Jérôme Schwartz, Daniel Beurrier, Pierre Yves Zinzius, Maheshwar Pauriah, Christian de Chillou, Jean Paul Lethor, Jean L. Cloez
Rok vydání:	2013
Předmět:	medicine.medical_specialty Atrial pacing biology business.industry Group ii Syncope (genus) Atrial fibrillation General Medicine Accessory pathway 030204 cardiovascular system & hematology medicine.disease biology.organism_classification WPW SYNDROME Atrioventricular reentrant tachycardia 3. Good health 03 medical and health sciences 0302 clinical medicine Internal medicine Age related medicine Cardiology 030212 general & internal medicine Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and Clinical Electrophysiology. 36:803-810
ISSN:	0147-8389
DOI:	10.1111/pace.12110
Popis:	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.
Databáze:	OpenAIRE
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