Incidence and mechanism of presyncope and/or syncope associated with paroxysmal junctional tachycardia

Brembilla‐Perrot, Béatrice; Beurrier, Daniel; Houriez, P.; Claudon, O.; Wertheimer, J.

doi:10.1016/s0002-9149(01)01607-1

Cited by 35 publications

(27 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Symptoms such as fatigue, dizziness, and cold sweat are common and may contribute to a feeling of insecurity because of arrhythmia problems and lead to self-imposed restrictions in a person's daily life. [5][6][7]31 A study describing patients with SVT showed that as many as 50% had been near syncope while having h e a r t & l u n g 4 0 ( 2 0 1 1 ) 4 0 5 e4 1 1 a tachycardia attack and 14% had experienced syncope. 6 In a qualitative study, Wood et al 8 described the situation of patients with SVT.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of radiofrequency ablation on health-related quality of life in patients with paroxysmal supraventricular tachycardia compared with a norm population one year after treatment

Walfridsson

Årestedt

et al. 2011

Heart & Lung

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…Frequent attacks are known to have considerable effects on the HRQOL. [4][5][6][7] In a few cases, the tachycardia attacks are not the only problem. Some patients report not being believed or having the symptoms trivialized, thus prolonging the correct diagnosis.…”

mentioning

confidence: 99%

Impact of radiofrequency ablation on health-related quality of life in patients with paroxysmal supraventricular tachycardia compared with a norm population one year after treatment

Walfridsson

Årestedt

et al. 2011

Heart & Lung

View full text Add to dashboard Cite

“…This last cause could be a frequent cause of syncope, but remains difficult to prove: salvos of atrial premature beats on 24 h Holter monitoring are frequent and not specific. However, the relationships between syncope and supraventricular tachyarrhythmias were previously reported [17,23,24]. In patients with low ejection fraction, a rapid supraventricular tachyarrhythmia can induce a decrease of cardiac output.…”

Section: Discussionmentioning

confidence: 99%

“…Isoproterenol also is used during electrophysiologic study to facilitate the induction of supraventricular and ventricular tachycardias [12][13][14][15][16]. Supraventricular tachycardia [17] and ventricular tachycardia [18,19] can explain syncope.…”

mentioning

confidence: 99%

Increased sensitivity of electrophysiological study by isoproterenol infusion in unexplained syncope

Brembilla‐Perrot¹,

Iyad²,

Marçon³

et al. 2006

International Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

“…The association of supraventricular tachycardia with high vagal tone has been reported to result in syncope. 15 Syncope has not been found to be a clinical predictor of VF, 16 and the occurrence of syncope had low sensitivity and specificity for predicting rapid heart rates. 17 Another study demonstrated that AVRT per se was a common cause of syncope, 18 even though the maximum rate over the AP was not higher in patients with syncope than in those without it.…”

Section: Article See P 661mentioning

confidence: 98%

Risk of Sudden Death in Wolff-Parkinson-White Syndrome

et al. 2012

View full text Add to dashboard Cite

Dudley White described a case series of 11 patients with a syndrome that now bears their name. 1 The first patient with a short PR interval, ventricular preexcitation, and supraventricular tachycardia was described by Cohn and Fraser in 1913. 1 Wood et al postulated the accessory pathway (AP) as its anatomic substrate in 1942, and a large population series reported the prevalence of preexcitation to be 0. 15% in 1962. 2 Reports in 1971 and 1979 described sudden cardiac death (SCD) in patients with Wolff-Parkinson-White (WPW) syndrome related to atrial fibrillation (AF) that was conducted rapidly over the AP with a short refractory period that deteriorated into ventricular fibrillation (VF). 3,4 The first operative ablation of an AP was performed by Sealy in 1967, 1 whereas Weber and Schmitz described the first endocardial catheter ablation of an AP in 1983. 1 The evolution of curative catheter ablation has clearly become the treatment of choice in the patient with substantive symptoms. A continuing controversy has been the use of this therapy in the asymptomatic or less symptomatic individual, and the central looming theme is the incidence of SCD as part of the natural history of this entity and our ability to predict it. The incidence of SCD in symptomatic patients with WPW syndrome was initially reported in the late 1960s and is estimated to be in the range of 0.25% per year, or 3% to 4% over a lifetime. 5 Article see p 661A number of risk factors for development of SCD have emerged, 6 including (1) shortest preexcited RR interval (SPRRI) during AF 4 and its surrogate, the antegrade effective refractory period (ERP) of the AP; (2) multiple APs; (3) male gender 7 ; (4) a history of or inducibility of atrioventricular reentrant tachycardia (AVRT); (5) age; and (6) syncope.In a large, early series of patients resuscitated from VF related to WPW syndrome, a SPRRI of Ͼ250 ms was not observed, and a range of 200 ms or less was the norm. 4 Most patients in this series had inducible AVRT, and others reported vulnerability to AF and inducible AVRT as risk factors. 7 Although a SPRRI Ͻ250 ms has been virtually uniformly present in patients with VF, many more patients never destined to have sudden death also have this risk factor, which gives it a poor positive predictive value (PPV) with a high negative predictive value (NPV). 8 Thus, a SPRRI of Ͻ250 ms and its surrogate, an antegrade ERP of Ͻ250 ms, have virtually 100% NPV but poor PPV. 9 A SPRRI Ͻ250 ms remains the pivotal risk factor without which VF related to AF would be rare indeed. Requiring the presence of multiple risk factors in combination would be expected to improve specificity but at the risk of loss of sensitivity.The only uncontestable and meaningful end point for accurate risk assessment is the SCD rate, which fortunately is very low. Nonetheless, this low event rate challenges the accuracy of any predictor, including electrophysiological studies. A high NPV reported for risk stratifiers is not meaningful in this context, and it must be borne in min...

show abstract

Incidence and mechanism of presyncope and/or syncope associated with paroxysmal junctional tachycardia

Cited by 35 publications

References 22 publications

Impact of radiofrequency ablation on health-related quality of life in patients with paroxysmal supraventricular tachycardia compared with a norm population one year after treatment

Impact of radiofrequency ablation on health-related quality of life in patients with paroxysmal supraventricular tachycardia compared with a norm population one year after treatment

Increased sensitivity of electrophysiological study by isoproterenol infusion in unexplained syncope

Risk of Sudden Death in Wolff-Parkinson-White Syndrome

Contact Info

Product

Resources

About