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To correlate the antegrade effective refractory period of the accessory pathway with its anatomical location in the heart.
To investigate whether the accessory pathway location can predict the high risk nature of the accessory pathway
The Wolf-Parkinson-White (WPW) syndrome is a clinical entity characterized by the presence of ≥1 accessory pathways between the atria and the ventricles pre-disposing patients to arrhythmias. Anterograde conduction through the accessory pathway leads to preexcitation of the ventricles and a delta wave in the ECG. The prevalence of preexcitation in the general population has been estimated to be 1 to 3 in 1000 individuals. Although most asymptomatic patients with pre-excitation have a good prognosis, there is also a lifetime risk of malignant arrhythmias and SCD, estimated to be 0.1 % per patient year.
These debatable relations between AP location and its risk stratification was not extensively studied in larger scale studies….
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Wolff Parkinson White patients | The investigators will decide the location of the AP by: - Invasively: if the patient is subjected to (EPS) • There are different locations of AP To assess whether the AP is of high risk or not, for all patients the Antegrade refractory period of the APAERP of the AP will be determined by one of the following ways: ( AERP) is measured during EPS as the shortest cycle length with one-to-one conduction over the AP by incremental atrial stimulation after which the QRS becomes narrow or no conduction occurs due to block of the impulse in the AP. The shortest pre-excited R-R interval (SPERRI) during spontaneous or induced AF. The AERP and the risk category of the AP according to its value, will be recorded in relation to the site of the AP determined in every case and compared between different accessory Locations to see whether some of these positions are more liable to be of higher risk or there is no differerence between different positions. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| electrophysiological study | Procedure | To assess whether the AP is of high risk or not, for all patients the AERP of the AP will be determined by one of the following ways: The cycle length at which abrupt and complete loss of pre-excitation occurs during exercise test. If this didn't happen, the patient will be subjected to invasive electrophysiologic study.. The Antegrade refractory period of the AP is measured during EPS as the shortest cycle length with one-to-one conduction over the AP by incremental atrial stimulation after which the QRS becomes narrow or no conduction occurs due to block of the impulse in the AP. The shortest pre-excited R-R interval during spontaneous or induced AF. |
| Measure | Description | Time Frame |
|---|---|---|
| the antegrade refractory period during invasive EPS done for the patients | the values will be correlated to the site of the AP diagnosed be EPS.. according to the previous studies and the current guidelines, if the refractory period is < 250 ms, this is considered a high risk AP | 2 hours |
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Inclusion criteria:
all patients with WPW admitted to Assuit university hospital and subjected to invasive EPS
Exclusion criteria:
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Wolff Parkinson White patients
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| M K Ibrahim, Msc | Contact | 1152453334 | +20 | mohamed011354@med.au.edu.eg |
| Name | Affiliation | Role |
|---|---|---|
| M K Ibrahim, Msc | Assiut University | Principal Investigator |
| S S Atta, Professor | Assiut University | Study Director |
| S M Taha, Lecturer |
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| ID | Type | URL | Comment |
|---|---|---|---|
| Pubmed | View IPD |
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| ID | Term |
|---|---|
| D014927 | Wolff-Parkinson-White Syndrome |
| ID | Term |
|---|---|
| D011226 | Pre-Excitation Syndromes |
| D001145 | Arrhythmias, Cardiac |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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|
| Assiut University |
| Study Director |
| D000075224 |
| Cardiac Conduction System Disease |
| D006330 | Heart Defects, Congenital |
| D018376 | Cardiovascular Abnormalities |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |