Association Between Atrial Fibrillation Occurrence and Wolff-Parkinson-White Syndrome: Is Prediction Possible?

Area of Science:

• Cardiology
• Electrophysiology
• Medical Research

Background:

• Wolff-Parkinson-White (WPW) syndrome is frequently associated with atrial fibrillation (AF).
• Predictors for AF occurrence in WPW patients remain unclear.
• Understanding these factors is crucial for risk stratification and management.

Purpose of the Study:

• To determine the prevalence of clinical and electrophysiological study (EPS)-induced AF.
• To identify factors associated with AF in a large cohort of WPW patients undergoing accessory pathway (AP) ablation.

Main Methods:

• Retrospective analysis of 845 consecutive WPW patients undergoing AP ablation.
• Standardized EPS protocol and multivariable logistic regression.
• Outcomes included clinical AF, EPS-induced AF, and composite AF outcomes.

Main Results:

• Left lateral AP location (ORa 2.31) and older age (per-year ORa 1.018) independently predicted clinical AF.
• Posterior AP location (ORa 1.78) predicted EPS-induced AF.
• Male sex was associated with higher EPS-induced AF, while female sex had lower odds (ORa 0.56).

Conclusions:

• Left lateral APs and older age are linked to higher clinical AF prevalence in WPW patients.
• Posterior APs and male sex are associated with increased likelihood of EPS-induced AF.
• Findings aid in predicting AF risk during AP ablation procedures.