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The Pan African Medical Journal 2022
Topics: Humans; Wolff-Parkinson-White Syndrome
PubMed: 36879639
DOI: 10.11604/pamj.2022.43.177.32528 -
Hellenic Journal of Cardiology : HJC =... 2023
Topics: Humans; Adolescent; Arrhythmias, Cardiac; Electrocardiography; Athletes; Wolff-Parkinson-White Syndrome
PubMed: 36868477
DOI: 10.1016/j.hjc.2023.02.005 -
Indian Heart Journal 2023radiofrequency catheter ablation (RFA) is the first-line therapy for symptomatic Wolff Parkinson White (WPW) patients according to the American Heart Association. We... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
radiofrequency catheter ablation (RFA) is the first-line therapy for symptomatic Wolff Parkinson White (WPW) patients according to the American Heart Association. We conducted this study to assess the success rate, recurrence rate, and rate of complications associated with the utilization of radiofrequency catheter ablation for managing patients with WPW.
METHOD
We searched PubMed, Cochrane library, Web of Science and Scopus databases using all identified keywords and index terms through 4 January 2022. We included all studies conducted on WPW patients who were treated with ablation. We conducted the analysis using Open Meta Analyst and MedCalc version 19.1.
RESULTS
Among 2268 unique articles identified, only 11 articles met our inclusion criteria. The pooled effect estimates showed high success rate (94.1%[95%CI:92.3-95.9], p < 0.001)), low recurrence rate (6.2% [95%CI:4.5-7.8, p < 0.001]) and low rate of complications (1%[95%CI:0.4-1.5, p < 0.001]).
CONCLUSION
RFA showed a high success rate, low recurrence rate and low rate of complications in WPW patients.
Topics: United States; Humans; Wolff-Parkinson-White Syndrome; Catheter Ablation; American Heart Association; Data Management
PubMed: 36758831
DOI: 10.1016/j.ihj.2023.02.001 -
JACC. Clinical Electrophysiology Jan 2023Guidelines for electrophysiology study (EPS) and catheter ablation in Wolff-Parkinson-White (WPW) are age based, but size may be a more relevant factor in determination...
BACKGROUND
Guidelines for electrophysiology study (EPS) and catheter ablation in Wolff-Parkinson-White (WPW) are age based, but size may be a more relevant factor in determination of outcomes.
OBJECTIVES
The goal of this study was to evaluate the association of patient weight with outcomes of catheter ablation for pediatric WPW.
METHODS
A multicenter retrospective cohort study was performed on children aged 1 to 21 years with WPW and first-time EPS from April 2016 to December 2019 recorded in the IMPACT (Improving Pediatric and Adult Congenital Treatment) registry, excluding those with congenital heart disease, cardiomyopathy, and >1 ablation target. A weight threshold of 30 kg was selected, representing 1 SD below the cohort mean. The primary outcome was major adverse events (MAEs); additional outcomes included deferred ablation, use of cryoablation, and ablation success.
RESULTS
A total of 4,456 subjects from 84 centers were evaluated, with 14% weighing <30 kg. Subjects weighing <30 kg were more likely to have preprocedural supraventricular tachycardia (45% vs 29%; P < 0.001) and less likely to have right septal accessory pathways (25% vs 33%; P < 0.001). MAEs were rare, although with higher incidence in the <30 kg cohort (0.3% vs 0.05%; P = 0.04). No difference was seen in likelihood of deferred ablation (9% vs 12%; P = 0.07) or use of cryoablation (11% vs 11%; P = 0.70). Success was higher in the <30 kg cohort: 95% vs 92% (P = 0.009). This effect persisted after adjusting for covariates (odds ratio: 1.6; 95% CI: 1.01-2.70; P = 0.046).
CONCLUSIONS
Weight <30 kg was associated with a small but elevated risk of MAEs. Rates of deferred ablation and cryoablation were similar. Adjusting for factors (including accessory pathway type and location), weight <30 kg remained an independent predictor of acute success.
Topics: Adult; Humans; Child; Wolff-Parkinson-White Syndrome; Retrospective Studies; Accessory Atrioventricular Bundle; Tachycardia, Supraventricular; Registries
PubMed: 36697203
DOI: 10.1016/j.jacep.2022.08.023 -
HeartRhythm Case Reports Jan 2023
PubMed: 36685684
DOI: 10.1016/j.hrcr.2022.10.003 -
Europace : European Pacing,... Feb 2023
Topics: Humans; Microelectrodes; Heart Conduction System; Atrioventricular Node; Bundle of His; Catheter Ablation; Electrocardiography; Wolff-Parkinson-White Syndrome
PubMed: 36634051
DOI: 10.1093/europace/euac271 -
Life (Basel, Switzerland) Dec 2022PRKAG2 syndrome (PS) is a rare, early-onset autosomal dominant phenocopy of sarcomeric hypertrophic cardiomyopathy (HCM), that mainly presents with ventricular... (Review)
Review
PRKAG2 syndrome (PS) is a rare, early-onset autosomal dominant phenocopy of sarcomeric hypertrophic cardiomyopathy (HCM), that mainly presents with ventricular pre-excitation, cardiac hypertrophy and progressive conduction system degeneration. Its natural course, treatment and prognosis are significantly different from sarcomeric HCM. The clinical phenotypes of PRKAG2 syndrome often overlap with HCM due to sarcomere protein mutations, causing this condition to be frequently misdiagnosed. The syndrome is caused by mutations in the gene encoding for the γ2 regulatory subunit (PRKAG2) of 5′ Adenosine Monophosphate-Activated Protein Kinase (AMPK), an enzyme that modulates glucose uptake and glycolysis. PRKAG2 mutations (OMIM#602743) are responsible for structural changes of AMPK, leading to an impaired myocyte glucidic uptake, and finally causing storage cardiomyopathy. We describe the clinical and investigative findings in a family with several affected members (NM_016203.4:c.905G>A or p.(Arg302Gln), heterozygous), highlighting the various phenotypes even in the same family, and the utility of genetic testing in diagnosing PS. The particularity of this family case is represented by the fact that the index patient was diagnosed at age 16 with cardiac hypertrophy and ventricular pre-excitation while his mother, by age 42, only had Wolff−Parkinson−White syndrome, without left ventricle hypertrophy. Both the grandmother and the great-grandmother underwent pacemaker implantation at a young age because of conduction abnormalities. Making the distinction between PS and sarcomeric HCM is actionable, given the early-onset of the disease, the numerous life-threatening consequences and the high rate of conduction disorders. In patients who exhibit cardiac hypertrophy coexisting with ventricular pre-excitation, genetic screening for PRKAG2 mutations should be considered.
PubMed: 36556501
DOI: 10.3390/life12122136 -
Children (Basel, Switzerland) Dec 2022We aimed to assess the accuracy of determining accessory pathway (AP) localization from 12 lead ECG tracings by applying 12 different algorithms in pediatric patients...
We aimed to assess the accuracy of determining accessory pathway (AP) localization from 12 lead ECG tracings by applying 12 different algorithms in pediatric patients diagnosed with Wolff-Parkinson-White syndrome. We compared algorithm accuracy in electrophysiologic study ECG tracings with full preexcitation and resting ECG tracings. The assessing pediatric cardiologists were blinded regarding EP study results on AP localization. For exact AP location, the algorithms published by D'Avila et al. and Boersma et al. yielded the highest accuracy (58%). Distinguishing laterality, the median accuracy for predicting left or right-sided APs was 74%, while for septal APs it was 68%. We conclude that algorithms predicting AP location in pediatric patients with Wolff-Parkinson-White syndrome show low accuracy for exact AP localization. For laterality, however, accuracy was significantly higher.
PubMed: 36553406
DOI: 10.3390/children9121962 -
Arquivos Brasileiros de Cardiologia Dec 2022
Topics: Humans; Heart Ventricles; Wolff-Parkinson-White Syndrome; Mutation; AMP-Activated Protein Kinases
PubMed: 36541985
DOI: 10.36660/abc.20220795 -
Europace : European Pacing,... Feb 2023Accessory pathway (AP) ablation is a standard procedure for the treatment of Wolff-Parkinson-White syndrome (WPW). Twelve-lead electrocardiogram (ECG)-based delta wave...
AIMS
Accessory pathway (AP) ablation is a standard procedure for the treatment of Wolff-Parkinson-White syndrome (WPW). Twelve-lead electrocardiogram (ECG)-based delta wave analysis is essential for predicting ablation sites. Previous algorithms have shown to be complex, time-consuming, and unprecise. We aimed to retrospectively develop and prospectively validate a new, simple ECG-based algorithm considering the patients' heart axis allowing for exact localization of APs in patients undergoing ablation for WPW.
METHODS AND RESULTS
Our multicentre study included 211 patients undergoing ablation of a single manifest AP due to WPW between 2013 and 2021. The algorithm was developed retrospectively and validated prospectively by comparing its efficacy to two established ones (Pambrun and Arruda). All patients (32 ± 19 years old, 47% female) underwent successful pathway ablation. Prediction of AP-localization was correct in 197 patients (93%) (sensitivity 92%, specificity 99%, PPV 96%, and NPV 99%). Our algorithm was particularly useful in correctly localizing antero-septal/-lateral (sensitivity and specificity 100%) and posteroseptal (sensitivity 98%, specificity 92%) AP in proximity to the tricuspid valve. The accuracy of EASY-WPW was superior compared to the Pambrun (93% vs. 84%, P = 0.003*) and the Arruda algorithm (94% vs. 75%, P < 0.001*). A subgroup analysis of children (n = 58, 12 ± 4 years old, 55% female) revealed superiority to the Arruda algorithm (P < 0.001*). The reproducibility of our algorithm was excellent (ϰ>0.8; P < 0.001*).
CONCLUSION
The novel EASY-WPW algorithm provides reliable and accurate pre-interventional ablation site determination in WPW patients. Only two steps are necessary to locate left-sided AP, and three steps to determine right-sided AP.
Topics: Humans; Adult; Child; Female; Adolescent; Young Adult; Middle Aged; Male; Wolff-Parkinson-White Syndrome; Retrospective Studies; Reproducibility of Results; Catheter Ablation; Accessory Atrioventricular Bundle; Electrocardiography; Algorithms
PubMed: 36504238
DOI: 10.1093/europace/euac216