Dual AV node pathway physiology in patients with Wolff-Parkinson-White syndrome

Yi Jen Chen, Shih Ann Chen, Chern En Chiang, Ching Tai Tai, Shih Huang Lee, Chuen Wang Chiou, Kwo Chang Ueng, Zu Chin Wen, Wen Chung Yu, Mau Song Chang

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Abstract

Published data on the relationship between dual AV node pathway physiology, locations and numbers of accessory pathways are limited. The purpose of this study is to appraise the dual AV node pathway physiology in a large group of patients with accessory AV pathways. A consecutive series of 759 patients was included for analysis. The incidence of antegrade or retrograde dual AV node pathway physiology and AV node reentrant tachycardia was similar for patients with accessory pathway at different locations. However, the incidence of bidirectional dual AV node pathway physiology (11.1%) and fast-slow type AV node reentrant echo (8.3%) was significantly higher in anteromidseptal accessory pathways. The incidence of antegrade (24.2% vs. 30.8%, P>0.05), retrograde (4.9% vs. 2.9%, P>0.05) and bidirectional dual AV node pathway physiology (3.0% vs. 2.9%, P>0.05) was similar between the patients with a single pathway and multiple accessory pathways. Furthermore, the patients with multiple accessory pathways had a higher incidence of slow-fast form AV node reentrant tachycardia (8.8% vs. 3.0%, P=0.034) and fast-slow form AV node reentrant echo (8.8% vs. 2.7%, P=0.02). Thirty-four patients (4.5%) received slow pathway ablation for AV node reentrant tachycardia and none had recurrent tachycardia during the follow up period (26±7, range 1-56 months). We conclude that it is possible to find dual AV node pathway physiology in patients with accessory pathways because this phenomenon was not rare, especially in patients with a single pathway located in the anteromidseptal area or in patients with multiple accessory pathways.

Original languageEnglish
Pages (from-to)275-281
Number of pages7
JournalInternational Journal of Cardiology
Volume56
Issue number3
DOIs
Publication statusPublished - Oct 25 1996
Externally publishedYes

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Keywords

  • accessory pathway
  • dual AV node pathway

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Chen, Y. J., Chen, S. A., Chiang, C. E., Tai, C. T., Lee, S. H., Chiou, C. W., Ueng, K. C., Wen, Z. C., Yu, W. C., & Chang, M. S. (1996). Dual AV node pathway physiology in patients with Wolff-Parkinson-White syndrome. International Journal of Cardiology, 56(3), 275-281. https://doi.org/10.1016/0167-5273(96)02762-3