New observations on atrial fibrillation before and after surgical treatment in patients with the Wolff-Parkinson-White syndrome

Department of Medicine, Duke University Medical Center, Durham, North Carolina.

The records of 342 patients who received surgical treatment for the Wolff-Parkinson-White syndrome between 1968 and 1986 were reviewed to evaluate the characteristics of atrial fibrillation. The patients were classified into two groups according to the presence (n = 166) or absence (n = 176) of documented episodes of atrial fibrillation preoperatively. The mean follow-up duration was 6 years (range 2 to 20). As compared with reports based on smaller patient groups and shorter follow-up, the study revealed several new findings. 1) During follow-up, nine patients in the atrial fibrillation group developed recurrent atrial fibrillation after a successful operation; five of these nine patients did not have associated heart disease. 2) All three patients with a history of atrial fibrillation and an accessory pathway conducting in the anterograde direction only had a successful surgical procedure and no postoperative atrial fibrillation. 3) The cycle length of atrioventricular (AV) reciprocating tachycardia was significantly shorter in the atrial fibrillation group (304 +/- 42 ms, mean +/- SD) than in the no-atrial fibrillation group (321 +/- 54 ms, p less than 0.005), and the cycle length of AV reciprocating tachycardia that degenerated into atrial fibrillation (289 +/- 26 ms) was shorter than that for the AV reciprocating tachycardia without subsequent atrial fibrillation (316 +/- 51 ms, p less than 0.005). 4) Sustained atrial fibrillation was induced in 30% of patients without a history of atrial fibrillation. 5) Atrial fibrillation occurred in four patients with an accessory pathway that conducted only in the retrograde direction.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				O. A. Centurion, A. Shimizu, S. Isomoto, and A. Konoe Mechanisms for the genesis of paroxysmal atrial fibrillation in the Wolff--Parkinson--White syndrome: intrinsic atrial muscle vulnerability vs. electrophysiological properties of the accessory pathway Europace, March 1, 2008; 10(3): 294 - 302. [Abstract] [Full Text] [PDF]

				A. L. Waldo and G. K. Feld Inter-Relationships of Atrial Fibrillation and Atrial Flutter: Mechanisms and Clinical Implications J. Am. Coll. Cardiol., February 26, 2008; 51(8): 779 - 786. [Abstract] [Full Text] [PDF]

				Y. Okuyama, Y. Miyauchi, A. M. Park, A. Hamabe, S. Zhou, H. Hayashi, M. Miyauchi, C. Omichi, H.-N. Pak, L. A. Brodsky, et al. High resolution mapping of the pulmonary vein and the vein of marshall during induced atrial fibrillation and atrial tachycardia in a canine model of pacing-induced congestive heart failure J. Am. Coll. Cardiol., July 16, 2003; 42(2): 348 - 360. [Abstract] [Full Text] [PDF]

				H. Oddsson, N. Edvardsson, and H. Walfridsson Episodes of atrial fibrillation and atrial vulnerability after successful radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome Europace, January 1, 2002; 4(2): 201 - 206. [Abstract] [Full Text] [PDF]

				N Dagres, J.R Clague, H Lottkamp, G Hindricks, G Breithardt, and M Borggrefe Impact of radiofrequency catheter ablation of accessory pathways on the frequency of atrial fibrillation during long-term follow-up; High recurrence rate of atrial fibrillation in patients older than 50 years of age Eur. Heart J., March 1, 2001; 22(5): 423 - 427. [Abstract] [PDF]

				Y.-J. Chen, S.-A. Chen, C.-T. Tai, Z.-C. Wen, A.-N. Feng, Y.-A. Ding, and M.-S. Chang Role of atrial electrophysiology and autonomic nervous system in patients with supraventricular tachycardia and paroxysmal atrial fibrillation J. Am. Coll. Cardiol., September 1, 1998; 32(3): 732 - 738. [Abstract] [Full Text] [PDF]

				T. Ikeda, L. Czer, A. Trento, C. Hwang, J. J. C. Ong, D. Hough, M. C. Fishbein, W. J. Mandel, H. S. Karagueuzian, and P.-S. Chen \E Induction of Meandering Functional Reentrant Wave Front in Isolated Human Atrial Tissues Circulation, November 4, 1997; 96(9): 3013 - 3020. [Abstract] [Full Text]

				S.-A. Chen, C.-E. Chiang, C.-T. Tai, S.-H. Lee, C.-W. Chiou, K.-C. Ueng, Z.-C. Wen, C.-C. Cheng, and M.-S. Chang Longitudinal Clinical and Electrophysiological Assessment of Patients With Symptomatic Wolff-Parkinson-White Syndrome and Atrioventricular Node Reentrant Tachycardia Circulation, June 1, 1996; 93(11): 2023 - 2032. [Abstract] [Full Text]

				E. N. Prystowsky, D. W. Benson Jr, V. Fuster, R. G. Hart, G. N. Kay, R. J. Myerburg, G. V. Naccarelli, and D. G. Wyse Management of Patients With Atrial Fibrillation : A Statement for Healthcare Professionals From the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association Circulation, March 15, 1996; 93(6): 1262 - 1277. [Full Text]

				L. I. Ganz and P. L. Friedman Supraventricular Tachycardia N. Engl. J. Med., January 19, 1995; 332(3): 162 - 173. [Full Text] [PDF]