Joanna Zakrzewska

P1-63 FIRST EPISODE OF ATRIAL FIBRILLATION IN OVERT AND CONCEALED WOLF-PARKINSON-WHITE SYNDROME

Background: Long refractory period of the A-V node is a natural barrier, which protects the ventricles from too fast heart rhythm. In WPW syndrome, AF is particularly dangerous when accessory pathway (AP) has short refractory period. The aim of our study was to analyze the occurrence of AF in dependence on sex, age, property of AP and other factors (CHD, HT) Methods: 747 pts, mean age 35.5, underwent non-pharmacological treatment of WPW (years 1988-2005). 221 (39.5%) of them (68 F, 153 M) had documented atrial fibrillation. The results of 12 lead ECG Holter, ECG monitoring, and an echocardiography study were analyzed. Results: 140 pts (63.3%) have had episode of AF and AVRT, 79 (25,5%) only AF. 20 pts (9%) have documented VF. 18% had HT, 7,3% CHD, 13,7% changes in coronary arteries, 8,7% valvular heart disease. 20% underwent cardioversion. Women had the first episode of AF most frequently at 4 decade (25.5%), men at 3rd (27.6%). The mean age of the first AF episode in men was significantly lower than women (32.4 vs 39.6). More frequently AF occured in pts with left sided AP (61%) than right-sided (30%). Midseptal occurs seldom (9%). AF occurred most frequently in overt APs – 81.3% (intermittent – 11%, and concealed – 7.7%). Conclusions: Men have had AF episodes 2,2 times more often than woman. Pts with avrt have had AF earlier than pts without avrt (36 vs 46). Men have had first episode of AF earlier than women (32.4 vs 39.6).