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• W2025087056 abstract "Electrophysiologic intracardiac and noninvasive transesophageal testing, used to evaluate parameters of anterograde conduction across the accessory pathway, the refractory period and shortest atrial cycle length with 1:1 conduction over the pathway, were compared to assess the reliability of the noninvasive technique in identifying patients with Wolff-Parkinson-White syndrome, at risk of rapid ventricular response during atrial fibrillation when this arrhythmia is not inducible. Sixteen patients with Wolff-Parkinson-White syndrome were submitted both to invasive and transesophageal atrial stimulation. We evaluated both the functional and effective refractory periods of the accessory pathway, using the same drive cycle length, and the shortest cycle length with 1:1 atrioventricular conduction over the accessory pathway. There were no differences between the parameters obtained by intracardiac atrial stimulation and by transesophageal atrial stimulation. The two approaches correlated well: mean functional refractory periods of the accessory pathway were 285 ± 42 msec and 289 ± 32 msec, respectively (NS, r = 0.88); mean effective refractory periods of the accessory pathway were 267 ± 41 msec and 271 ± 32 msec, respectively (NS, r = 0.89); mean shortest cycle lengths with 1:1 conduction over the accessory pathway were 255 ± 48 msec and 255 ± 44 msec, respectively (NS, r = 0.94). These data demonstrate the reliability of transesophageal atrial stimulation in estimating the parameters for anterograde conduction across and accessory pathway. These results, and the already documented ability of transesophageal atrial stimulation to induce atrial fibrillation, suggest this noninvasive technique should be taken as a first approach in screening patients with Wolff-Parkinson-White syndrome. When sustained atrial fibrillation is not inducible by transesophageal stimulation, very short parameters obtained by both continuous and programmed pacing can identify patients at risk, thus avoiding intracardiac stimulation. On the other hand, long refractory periods are less useful because of their well-known limits as risk factors. In this case, intracardiac induction of atrial fibrillation is needed, even using alternating current." @default.
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• W2025087056 date "1991-02-01" @default.
• W2025087056 modified "2023-10-03" @default.
• W2025087056 title "Transesophageal versus intracardiac atrial stimulation in assessing anterograde conduction properties of the accessory pathway in Wolff-Parkinson-White syndrome" @default.
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• W2025087056 doi "https://doi.org/10.1016/0167-5273(91)90097-9" @default.
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