Usefulness of Severe Cardiac Sympathetic Dysfunction to Predict the Occurrence of Rapid Atrial Fibrillation in Patients With Wolff-Parkinson-White Syndrome
Atrial fibrillation (AF) can be a potentially life-threatening arrhythmia when it conducts rapidly through the accessory pathway, which was not predicted by the noninvasive method. We evaluated the cardiac sympathetic activity for predicting the occurrence of AF in patients with Wolff-Parkinson-Whit...
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| Veröffentlicht in: | The American journal of cardiology 2013-09, Vol.112 (5), p.688-693 |
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| creator | Akutsu, Yasushi, MD Kaneko, Kyouichi, MD Kodama, Yusuke, MD Li, Hui-Ling, MD Asano, Taku, MD Suyama, Jumpei, MD Tanno, Kaoru, MD Namiki, Atsuo, MD Shinozuka, Akira, MD Gokan, Takehiko, MD Kobayashi, Youichi, MD |
| description | Atrial fibrillation (AF) can be a potentially life-threatening arrhythmia when it conducts rapidly through the accessory pathway, which was not predicted by the noninvasive method. We evaluated the cardiac sympathetic activity for predicting the occurrence of AF in patients with Wolff-Parkinson-White (WPW) syndrome. Iodine-123 metaiodobenzylguanidine scintigraphy was performed under stable sinus rhythm conditions at rest |
| doi_str_mv | 10.1016/j.amjcard.2013.04.048 |
| format | Article |
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We evaluated the cardiac sympathetic activity for predicting the occurrence of AF in patients with Wolff-Parkinson-White (WPW) syndrome. Iodine-123 metaiodobenzylguanidine scintigraphy was performed under stable sinus rhythm conditions at rest <1 week before an electrophysiologic study (EPS) to assess the sympathetic activity using the heart/mediastinum (H/M) ratio in 45 consecutive patients with WPW who had a history of supraventricular tachycardia (mean ± SD, age: 47 ± 17 years, 42.2% women). The study also included 15 normal healthy volunteers (56 ± 17 years, 40% women). The H/M ratio was lower in patients with WPW syndrome than in the normal control group, and in the 15 patients with AF induced during EPS than in the 30 patients without AF (p <0.0001). The sensitivity of H/M ratio ≤2.8 for predicting the AF induced during EPS was 75% in 12 of 16 patients, and the specificity was 89.7% in 26 of 29 patients. The H/M ratio was positively correlated with anterograde effective refractory period (r = 0.514, p <0.0001). The sensitivity of H/M ratio ≤2.75 for predicting the AF with a short anterograde effective refractory period (≤250 ms) was 91.7% in 11 of 12 patients, and the specificity was 90.9% in 30 of 33 patients. In conclusion, the severe cardiac sympathetic dysfunction was associated with the occurrence of AF, particularly in those with rapid AF and in patients with WPW syndrome.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2013.04.048</identifier><identifier>PMID: 23711805</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>3-Iodobenzylguanidine ; Adult ; Aged ; Atrial Fibrillation - complications ; Atrial Fibrillation - diagnostic imaging ; Blood pressure ; Body mass index ; Cardiac arrhythmia ; Cardiovascular ; Case-Control Studies ; Confidence intervals ; Diabetes ; Electrophysiologic Techniques, Cardiac ; Enzymes ; Female ; Heart ; Heart - diagnostic imaging ; Heart - innervation ; Heart rate ; Humans ; Hypertension ; Male ; Mediastinum - diagnostic imaging ; Middle Aged ; Multivariate analysis ; Myocardial Perfusion Imaging ; Peptides ; Plasma ; Radiopharmaceuticals ; Regression analysis ; Severity of Illness Index ; Sympathetic Nervous System - diagnostic imaging ; Sympathetic Nervous System - physiopathology ; Tachycardia, Supraventricular - complications ; Tachycardia, Supraventricular - diagnostic imaging ; Wolff-Parkinson-White Syndrome - complications ; Wolff-Parkinson-White Syndrome - diagnostic imaging</subject><ispartof>The American journal of cardiology, 2013-09, Vol.112 (5), p.688-693</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Sep 1, 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-6a84486cd11c00c99177ca7d8626840fd5eb430217e127377aafb5c579106aed3</citedby><cites>FETCH-LOGICAL-c448t-6a84486cd11c00c99177ca7d8626840fd5eb430217e127377aafb5c579106aed3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914913010655$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23711805$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akutsu, Yasushi, MD</creatorcontrib><creatorcontrib>Kaneko, Kyouichi, MD</creatorcontrib><creatorcontrib>Kodama, Yusuke, MD</creatorcontrib><creatorcontrib>Li, Hui-Ling, MD</creatorcontrib><creatorcontrib>Asano, Taku, MD</creatorcontrib><creatorcontrib>Suyama, Jumpei, MD</creatorcontrib><creatorcontrib>Tanno, Kaoru, MD</creatorcontrib><creatorcontrib>Namiki, Atsuo, MD</creatorcontrib><creatorcontrib>Shinozuka, Akira, MD</creatorcontrib><creatorcontrib>Gokan, Takehiko, MD</creatorcontrib><creatorcontrib>Kobayashi, Youichi, MD</creatorcontrib><title>Usefulness of Severe Cardiac Sympathetic Dysfunction to Predict the Occurrence of Rapid Atrial Fibrillation in Patients With Wolff-Parkinson-White Syndrome</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Atrial fibrillation (AF) can be a potentially life-threatening arrhythmia when it conducts rapidly through the accessory pathway, which was not predicted by the noninvasive method. We evaluated the cardiac sympathetic activity for predicting the occurrence of AF in patients with Wolff-Parkinson-White (WPW) syndrome. Iodine-123 metaiodobenzylguanidine scintigraphy was performed under stable sinus rhythm conditions at rest <1 week before an electrophysiologic study (EPS) to assess the sympathetic activity using the heart/mediastinum (H/M) ratio in 45 consecutive patients with WPW who had a history of supraventricular tachycardia (mean ± SD, age: 47 ± 17 years, 42.2% women). The study also included 15 normal healthy volunteers (56 ± 17 years, 40% women). The H/M ratio was lower in patients with WPW syndrome than in the normal control group, and in the 15 patients with AF induced during EPS than in the 30 patients without AF (p <0.0001). The sensitivity of H/M ratio ≤2.8 for predicting the AF induced during EPS was 75% in 12 of 16 patients, and the specificity was 89.7% in 26 of 29 patients. The H/M ratio was positively correlated with anterograde effective refractory period (r = 0.514, p <0.0001). The sensitivity of H/M ratio ≤2.75 for predicting the AF with a short anterograde effective refractory period (≤250 ms) was 91.7% in 11 of 12 patients, and the specificity was 90.9% in 30 of 33 patients. In conclusion, the severe cardiac sympathetic dysfunction was associated with the occurrence of AF, particularly in those with rapid AF and in patients with WPW syndrome.</description><subject>3-Iodobenzylguanidine</subject><subject>Adult</subject><subject>Aged</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - diagnostic imaging</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular</subject><subject>Case-Control Studies</subject><subject>Confidence intervals</subject><subject>Diabetes</subject><subject>Electrophysiologic Techniques, Cardiac</subject><subject>Enzymes</subject><subject>Female</subject><subject>Heart</subject><subject>Heart - diagnostic imaging</subject><subject>Heart - innervation</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Male</subject><subject>Mediastinum - diagnostic imaging</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Myocardial Perfusion Imaging</subject><subject>Peptides</subject><subject>Plasma</subject><subject>Radiopharmaceuticals</subject><subject>Regression analysis</subject><subject>Severity of Illness Index</subject><subject>Sympathetic Nervous System - diagnostic imaging</subject><subject>Sympathetic Nervous System - physiopathology</subject><subject>Tachycardia, Supraventricular - complications</subject><subject>Tachycardia, Supraventricular - diagnostic imaging</subject><subject>Wolff-Parkinson-White Syndrome - complications</subject><subject>Wolff-Parkinson-White Syndrome - diagnostic imaging</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFUk1vEzEQtRCIpoWfALLEhcsGz3559wKqAgWkSo0IVY6WY88qTnft1PZWym_hz9ZLAki9II00tvzmzfi9IeQNsDkwqD_s5nLYKen1PGdQzFmZonlGZtDwNoMWiudkxhjLsxbK9oych7BLV4CqfknO8oIDNKyakV-3AbuxtxgCdR1d4QN6pIvEa6Siq8Owl3GL0Sj6-RC60aponKXR0aVHbVSk6ZXeKDV6j1bhxPFD7o2ml9Eb2dMrs_Gm7-XvMmPpMp3QxkDXJm7p2vVdly2lvzM2OJuttyZi6mq1dwO-Ii862Qd8fcoX5Pbqy8_Ft-z65uv3xeV1psqyiVktm5RrpQEUY6ptgXMluW7qvG5K1ukKN2XBcuAIOS84l7LbVKriLbBaoi4uyPsj7967-xFDFIMJCtPUFt0YBJR5zSAvKpag755Ad270Nk03oYDnSe06oaojSnkXgsdO7L0ZpD8IYGJyT-zEyT0xuSdYmaJJdW9P7ONmQP236o9dCfDpCMAkx4NBL4Iyk-7aeFRRaGf-2-LjEwbVG2uU7O_wgOHfb0TIBROraYWmDYKCJbWqqngE8qHDqw</recordid><startdate>20130901</startdate><enddate>20130901</enddate><creator>Akutsu, Yasushi, MD</creator><creator>Kaneko, Kyouichi, MD</creator><creator>Kodama, Yusuke, MD</creator><creator>Li, Hui-Ling, MD</creator><creator>Asano, Taku, MD</creator><creator>Suyama, Jumpei, MD</creator><creator>Tanno, Kaoru, MD</creator><creator>Namiki, Atsuo, MD</creator><creator>Shinozuka, Akira, MD</creator><creator>Gokan, Takehiko, MD</creator><creator>Kobayashi, Youichi, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20130901</creationdate><title>Usefulness of Severe Cardiac Sympathetic Dysfunction to Predict the Occurrence of Rapid Atrial Fibrillation in Patients With Wolff-Parkinson-White Syndrome</title><author>Akutsu, Yasushi, MD ; Kaneko, Kyouichi, MD ; Kodama, Yusuke, MD ; Li, Hui-Ling, MD ; Asano, Taku, MD ; Suyama, Jumpei, MD ; Tanno, Kaoru, MD ; Namiki, Atsuo, MD ; Shinozuka, Akira, MD ; Gokan, Takehiko, MD ; Kobayashi, Youichi, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-6a84486cd11c00c99177ca7d8626840fd5eb430217e127377aafb5c579106aed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>3-Iodobenzylguanidine</topic><topic>Adult</topic><topic>Aged</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - diagnostic imaging</topic><topic>Blood pressure</topic><topic>Body mass index</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular</topic><topic>Case-Control Studies</topic><topic>Confidence intervals</topic><topic>Diabetes</topic><topic>Electrophysiologic Techniques, Cardiac</topic><topic>Enzymes</topic><topic>Female</topic><topic>Heart</topic><topic>Heart - diagnostic imaging</topic><topic>Heart - innervation</topic><topic>Heart rate</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Male</topic><topic>Mediastinum - diagnostic imaging</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Myocardial Perfusion Imaging</topic><topic>Peptides</topic><topic>Plasma</topic><topic>Radiopharmaceuticals</topic><topic>Regression analysis</topic><topic>Severity of Illness Index</topic><topic>Sympathetic Nervous System - diagnostic imaging</topic><topic>Sympathetic Nervous System - physiopathology</topic><topic>Tachycardia, Supraventricular - 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Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akutsu, Yasushi, MD</au><au>Kaneko, Kyouichi, MD</au><au>Kodama, Yusuke, MD</au><au>Li, Hui-Ling, MD</au><au>Asano, Taku, MD</au><au>Suyama, Jumpei, MD</au><au>Tanno, Kaoru, MD</au><au>Namiki, Atsuo, MD</au><au>Shinozuka, Akira, MD</au><au>Gokan, Takehiko, MD</au><au>Kobayashi, Youichi, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of Severe Cardiac Sympathetic Dysfunction to Predict the Occurrence of Rapid Atrial Fibrillation in Patients With Wolff-Parkinson-White Syndrome</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2013-09-01</date><risdate>2013</risdate><volume>112</volume><issue>5</issue><spage>688</spage><epage>693</epage><pages>688-693</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Atrial fibrillation (AF) can be a potentially life-threatening arrhythmia when it conducts rapidly through the accessory pathway, which was not predicted by the noninvasive method. We evaluated the cardiac sympathetic activity for predicting the occurrence of AF in patients with Wolff-Parkinson-White (WPW) syndrome. Iodine-123 metaiodobenzylguanidine scintigraphy was performed under stable sinus rhythm conditions at rest <1 week before an electrophysiologic study (EPS) to assess the sympathetic activity using the heart/mediastinum (H/M) ratio in 45 consecutive patients with WPW who had a history of supraventricular tachycardia (mean ± SD, age: 47 ± 17 years, 42.2% women). The study also included 15 normal healthy volunteers (56 ± 17 years, 40% women). The H/M ratio was lower in patients with WPW syndrome than in the normal control group, and in the 15 patients with AF induced during EPS than in the 30 patients without AF (p <0.0001). The sensitivity of H/M ratio ≤2.8 for predicting the AF induced during EPS was 75% in 12 of 16 patients, and the specificity was 89.7% in 26 of 29 patients. The H/M ratio was positively correlated with anterograde effective refractory period (r = 0.514, p <0.0001). The sensitivity of H/M ratio ≤2.75 for predicting the AF with a short anterograde effective refractory period (≤250 ms) was 91.7% in 11 of 12 patients, and the specificity was 90.9% in 30 of 33 patients. In conclusion, the severe cardiac sympathetic dysfunction was associated with the occurrence of AF, particularly in those with rapid AF and in patients with WPW syndrome.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23711805</pmid><doi>10.1016/j.amjcard.2013.04.048</doi><tpages>6</tpages></addata></record> |
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| ispartof | The American journal of cardiology, 2013-09, Vol.112 (5), p.688-693 |
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| subjects | 3-Iodobenzylguanidine Adult Aged Atrial Fibrillation - complications Atrial Fibrillation - diagnostic imaging Blood pressure Body mass index Cardiac arrhythmia Cardiovascular Case-Control Studies Confidence intervals Diabetes Electrophysiologic Techniques, Cardiac Enzymes Female Heart Heart - diagnostic imaging Heart - innervation Heart rate Humans Hypertension Male Mediastinum - diagnostic imaging Middle Aged Multivariate analysis Myocardial Perfusion Imaging Peptides Plasma Radiopharmaceuticals Regression analysis Severity of Illness Index Sympathetic Nervous System - diagnostic imaging Sympathetic Nervous System - physiopathology Tachycardia, Supraventricular - complications Tachycardia, Supraventricular - diagnostic imaging Wolff-Parkinson-White Syndrome - complications Wolff-Parkinson-White Syndrome - diagnostic imaging |
| title | Usefulness of Severe Cardiac Sympathetic Dysfunction to Predict the Occurrence of Rapid Atrial Fibrillation in Patients With Wolff-Parkinson-White Syndrome |
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