Abstract 11018: Age-related Prognosis of Syncope Associated With a Preexcitation Syndrome
Background: Vagal-related syncope represents the most frequent cause of syncope in population Syncope in Wolff-Parkinson-White syndrome (WPW) can be without relationships with WPW, but also may reveal a poorly-tolerated arrhythmia. Electrophysiologic study (EPS) is recommended to evaluate the cause of syncope. The purpose of the study was to evaluate the influence of the age of the patient on the causes of syncope. Population: 97 patients, 51 males, 46 females, mean age 35±17 years, with WPW were admitted for unexplained dizziness and/or syncope; they had no other heart disease and no documented arrhythmias; 29 patients were aged from 9 to 19 years (mean 15±1.4)(children and teenagers/group I), 44 from 20 to 49 years (mean 34±8)(adults/group II) and 24 from 50 to 70 years (mean 60±8)(elderly/group III).
Methods: EPS consisted of atrial pacing and programmed atrial stimulation using 1 and 2 extrastimuli in control state and after isoproterenol.
Results: EPS could be negative (no inducible tachycardia) or orthodromic atrioventricular reentrant tachycardia (AVRT) complicated or not by a vagal reaction or a rapid atrial fibrillation (AF) could be induced. A potentially malignant form (rapid conduction in accessory pathway (AP) >240 bpm in control state or >300 bpm after isoproterenol and AF or antidromic tachycardia induction) was noted in 10 group I patients (34%) more frequently than in group II (5/44)(11%)(p <0.017) and III (0/24)(0%)(p<0.001). Differences between groups II and III were not significant (0.08). AVRT was induced in 10 group I patients (34%), 20 group II patients (45%)(NS) and 15 group III patients (62.5%). Differences between group I and III were significant (p<0.04). No tachycardia was induced in 9 group I patients (31%), 19 group II patients (43%)(NS) and 9 group III patients (37.5%)(NS).
Conclusion: Prognosis of syncope occurring in patients with a WPW syndrome was associated with the age of the patient. A malignant form as a cause of syncope was frequently noted in children and teenagers, rarely in adults and never in elderly. AV reentrant tachycardia was more frequent in elderly patients than in the youth. Electrophysiologic study is required urgently in case of syncope in children and teenagers with a preexcitation syndrome.
- © 2012 by American Heart Association, Inc.