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Usefulness of severe cardiac sympathetic dysfunction to predict the occurrence of rapid atrial fibrillation in patients with Wolff-Parkinson-White syndrome.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2013 Sep 01; Vol. 112 (5), pp. 688-93. Date of Electronic Publication: 2013 May 24. - Publication Year :
- 2013
-
Abstract
- Atrial fibrillation (AF) can be a potentially life-threatening arrhythmia when it conducts rapidly through the accessory pathway, which was not predicted by the noninvasive method. We evaluated the cardiac sympathetic activity for predicting the occurrence of AF in patients with Wolff-Parkinson-White (WPW) syndrome. Iodine-123 metaiodobenzylguanidine scintigraphy was performed under stable sinus rhythm conditions at rest <1 week before an electrophysiologic study (EPS) to assess the sympathetic activity using the heart/mediastinum (H/M) ratio in 45 consecutive patients with WPW who had a history of supraventricular tachycardia (mean ± SD, age: 47 ± 17 years, 42.2% women). The study also included 15 normal healthy volunteers (56 ± 17 years, 40% women). The H/M ratio was lower in patients with WPW syndrome than in the normal control group, and in the 15 patients with AF induced during EPS than in the 30 patients without AF (p <0.0001). The sensitivity of H/M ratio ≤2.8 for predicting the AF induced during EPS was 75% in 12 of 16 patients, and the specificity was 89.7% in 26 of 29 patients. The H/M ratio was positively correlated with anterograde effective refractory period (r = 0.514, p <0.0001). The sensitivity of H/M ratio ≤2.75 for predicting the AF with a short anterograde effective refractory period (≤250 ms) was 91.7% in 11 of 12 patients, and the specificity was 90.9% in 30 of 33 patients. In conclusion, the severe cardiac sympathetic dysfunction was associated with the occurrence of AF, particularly in those with rapid AF and in patients with WPW syndrome.<br /> (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Subjects :
- 3-Iodobenzylguanidine
Adult
Aged
Atrial Fibrillation complications
Case-Control Studies
Electrophysiologic Techniques, Cardiac
Female
Heart diagnostic imaging
Humans
Male
Middle Aged
Myocardial Perfusion Imaging
Radiopharmaceuticals
Severity of Illness Index
Sympathetic Nervous System physiopathology
Tachycardia, Supraventricular complications
Wolff-Parkinson-White Syndrome complications
Atrial Fibrillation diagnostic imaging
Heart innervation
Mediastinum diagnostic imaging
Sympathetic Nervous System diagnostic imaging
Tachycardia, Supraventricular diagnostic imaging
Wolff-Parkinson-White Syndrome diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 112
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 23711805
- Full Text :
- https://doi.org/10.1016/j.amjcard.2013.04.048