Dyspnoea related to pre-excitation during sinus rhythm as a new indication for catheter ablation

Stec, Sebastian; Szmit, Sebastian; Szydłowski, Lesław; Dudek, Konrad; Zagrodzka, Magdalena; Futyma, Marian; Opolski, Grzegorz; Kułakowski, Piotr

doi:10.5603/kp.a2014.0047

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…In clinical practice, some patients with ventricular preexcitation experience exertional dyspnea or impaired exercise tolerance. Cases of improvement of exercise intolerance after RFCA in patients with ventricular pre-excitation have also been reported (27)(28)(29). Using cardiopulmonary exercise testing, Książczyk et al (30) demonstrated impaired physical performance in asymptomatic children with ventricular preexcitation compared to matched healthy children (VO 2 max: 36.67±6.66 vs. 44.45±8.37 mL/kg/min; P<0.001).…”

Section: Exercise Intolerance In Patients With Ventricular Preexcitationmentioning

confidence: 93%

Radiofrequency catheter ablation for improving myocardial work in patients with ventricular pre-excitation

Zheng¹,

Zheng²,

Chang³

et al. 2023

Quant Imaging Med Surg

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Background: Previous studies have not consistently found significant improvements in left ventricular ejection fraction or global longitudinal strain (GLS) after radiofrequency catheter ablation (RFCA) in patients with ventricular pre-excitation. The aim of this study was thus to explore the effects of RFCA on left ventricular function in patients with ventricular pre-excitation using a new noninvasive echocardiographic method of myocardial work.Methods: A total of 34 patients with ventricular pre-excitation who underwent RFCA and 18 healthy controls were prospectively included in this study. Before and after participants underwent RFCA, electrocardiographic and echocardiographic data of the patients were collected at resting and pacing heart rates (HRs) of 100 beats per minute (bpm) and 120 bpm (controlled by high right atrial pacing during the procedure). Clinical data of the healthy controls at resting HR were also collected. A self-controlled paired sample t test was used to compare the differences before and after participants underwent RFCA.Results: After participants underwent RFCA, the global wasted work (GWW) of the included patients

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Section: Exercise Intolerance In Patients With Ventricular Preexcitationmentioning

confidence: 93%

Radiofrequency catheter ablation for improving myocardial work in patients with ventricular pre-excitation

Zheng¹,

Zheng²,

Chang³

et al. 2023

Quant Imaging Med Surg

View full text Add to dashboard Cite

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“…Moreover, patients aged 65 years or older had a significantly higher risk of death (HR, 1.85) when compared with patients without preexcitation. 23 Stec et al 24 reported a case series of patients with asymptomatic preexcitation with dyspnea and exercise intolerance. No organic disease in the cardiopulmonary system was found.…”

mentioning

confidence: 99%

Malignant ventricular arrhythmias and other complications of untreated accessory pathways: an analysis of prevalence and risk factors in over 600 ablation cases

Moskal¹,

Jastrzębski²,

Pitak³

et al. 2020

Kardiol Pol

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BACKGROUND The presence of accessory pathways (APs) is a risk factor for sudden cardiac death and other clinical complications. AIMS We aimed to characterize all adverse events likely related to the presence of APs in patients referred for AP ablation and to identify risk factors for malignant arrhythmias. METHODS We performed a retrospective analysis of consecutive patients referred for AP ablation from 2002 to 2017. Electrocardiograms, electrophysiological system records, and hospital discharge notes were reviewed. We collected data concerning symptoms before ablation, occurrence of ventricular fibrillation or malignant atrial fibrillation (AF), as well as other complications related to APs. RESULTS We identified 602 patients with APs. Serious AP-related events were observed in 41 patients, including 14 sudden cardiac arrests (1 death) and 16 pre-cardiac arrest events. Other complications included strokes, pulmonary edema, heart failure, and unnecessary device implantation. The risk of malignant arrhythmias decreased with a longer shortest preexcited RR interval (per 10 ms: odds ratio [OR], 1.3; 95% CI, 1.16-1.47) and increased with age (per 10 years: OR, 1.29; 95% CI, 1.06-1.57). The presence of inducible AF, but not sole atrioventricular reentrant tachycardia, increased the risk for malignant arrhythmias when compared with patients without any inducible arrhythmias. CONCLUSIONS Patients with APs referred for ablation commonly present with various adverse events. The predictive value of clinical risk factors for malignant arrhythmias is too low to prevent devastating consequences. When high safety and efficacy of AP ablation are ensured, even a low risk of sudden death is unacceptable and a lower threshold for prophylactic ablation should be used to prevent AP-related adverse events.

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Assessment of the physical performance in children with asymptomatic pre-excitation

Książczyk

Jaroń²,

Pietrzak

et al. 2021

EP Europace

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Aims Pre-excitation syndrome can lead to recurrent supraventricular tachycardias (SVTs) and carries a risk of sudden cardiac death (SCD). However, an underestimated consequence of antegrade conduction through an accessory pathway is fusion of intrinsic and accessory conduction that causes asynchronous activation and myocardial contraction that could be a cause for cardiac dysfunction and dilation. It is not known to what extent pre-excitation affects myocardial and physical performance in those patients. The aim of the study was to assess to what degree ventricular pre-excitation affects physical performance in children, using cardio-pulmonary exercise testing (CPET). Methods and results The study group consisted of 30 asymptomatic children, aged 8–17 years, with pre-excitation and no history or documentation of SVT compared to 31 healthy controls matched according to sex and age. All patients underwent routine cardiology assessment and then CPET. Echocardiography showed there were no differences in the left ventricular size and function between the study and control group. During the CPET both, patients and controls achieved maximal effort. Patients in the study group showed significantly lower values of VO2max and anaerobic threshold when compared to controls. The most affected subgroup was patients with persistent pre-excitation throughout the exercise. Conclusions Physical performance is affected in children with pre-excitation. This effect is stronger in patients with persistent delta wave observed throughout the exercise.

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Dyspnoea related to pre-excitation during sinus rhythm as a new indication for catheter ablation

Abstract: Dyspnoea during sinus rhythm in women with pre-excitation may be considered to be an evaluation criterion before RFA.

Cited by 4 publications

References 24 publications

Radiofrequency catheter ablation for improving myocardial work in patients with ventricular pre-excitation

Radiofrequency catheter ablation for improving myocardial work in patients with ventricular pre-excitation

Malignant ventricular arrhythmias and other complications of untreated accessory pathways: an analysis of prevalence and risk factors in over 600 ablation cases

Assessment of the physical performance in children with asymptomatic pre-excitation

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