Journal of cardiovascular electrophysiology · 2025
Intermittent Ventricular Pre-Excitation: Clinical Features and Electrophysiological Properties.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Robles Antonio Gianluca, Palamà Zefferino, Santoro Francesco, Rauber Martin, Antolič Bor, Gianfrancesco Domenico, Bartolomucci Francesco, Pellegrino Pierluigi, Alfieri Simona, Borelli Alessio, Scarà Antonio, Luca Gabriele De Masi De, de Ruvo Ermenegildo, Calò Leonardo, Jan Matevž, Pernat Andrej, Romano Silvio, Sciarra Luigi
Аннотация
BACKGROUND: Intermittent ventricular pre-excitation has long been considered a low-risk marker for sudden death. Accessory pathways (APs) with high-risk intermittent antegrade conductive properties may exist, but this still represents a gray area in current guidelines. We evaluated differences in risk characteristics between symptomatic and asymptomatic patients with intermittent pre-excitation (IPX) and those with persistent pre-excitation (PPX) in a multicenter international registry.
METHODS: 392 consecutive patients [IPX: 79 (20.15%); PPX: 313 (79.85%)] underwent electrophysiological (EP) study. Data on arrhythmia inducibility (AVRT/AF), AP antegrade conduction properties (ERP/SPERRI), site, and number were collected.
RESULTS: No significant differences were found in demographic characteristics and EP features between PPX and IPX patients, including antegrade conductive properties, prevalence of multiple APs, and AP locations, except for AVRT inducibility which was more frequent in IPX group. Similarly, no differences were detected between symptomatic and asymptomatic IPX patients.
CONCLUSIONS: Except for AVRT inducibility, our study shows no significant differences in demographic and other electrophysiological features between PPX and IPX patients. Likewise, no differences in demographic and EP features were detected between symptomatic and asymptomatic IPX patients. Therefore, intermittent pre-excitation is an unreliable noninvasive marker of arrhythmic risk and it warrants an invasive risk assessment via EP study.
METHODS: 392 consecutive patients [IPX: 79 (20.15%); PPX: 313 (79.85%)] underwent electrophysiological (EP) study. Data on arrhythmia inducibility (AVRT/AF), AP antegrade conduction properties (ERP/SPERRI), site, and number were collected.
RESULTS: No significant differences were found in demographic characteristics and EP features between PPX and IPX patients, including antegrade conductive properties, prevalence of multiple APs, and AP locations, except for AVRT inducibility which was more frequent in IPX group. Similarly, no differences were detected between symptomatic and asymptomatic IPX patients.
CONCLUSIONS: Except for AVRT inducibility, our study shows no significant differences in demographic and other electrophysiological features between PPX and IPX patients. Likewise, no differences in demographic and EP features were detected between symptomatic and asymptomatic IPX patients. Therefore, intermittent pre-excitation is an unreliable noninvasive marker of arrhythmic risk and it warrants an invasive risk assessment via EP study.