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Fatigue phenomenon in accessory pathways

H G Li1, G J Klein, R Yee

  • 1Department of Medicine, University of Western Ontario, London, Canada.

Journal of Cardiovascular Electrophysiology
|October 1, 1994
PubMed
Summary
This summary is machine-generated.

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Fatigue in accessory pathways is uncommon but has been studied. These pathways show a low conduction safety margin, suggesting they are unlikely to cause clinical problems.

Area of Science:

  • Electrophysiology
  • Cardiology

Background:

  • Fatigue is a transient conduction failure after repetitive excitation.
  • Fatigue in accessory pathways is rare, with unknown electrophysiologic characteristics and clinical implications.

Purpose of the Study:

  • To investigate the electrophysiologic characteristics and clinical implications of accessory pathway fatigue.

Main Methods:

  • Electrophysiology studies were performed on 215 patients between July 1992 and December 1993.
  • Four patients (2%) exhibited fatigue over accessory pathways, located posteroseptal or right free wall.

Main Results:

  • The mean anterograde effective refractory period was 295 +/- 26 msec.
  • Three patients showed no retrograde accessory pathway conduction or inducible tachycardia, even with isoproterenol.

Related Experiment Videos

  • Fatigue was observed after atrial and/or ventricular stimulation and was duration-dependent.

    • Conclusions:

    • Accessory pathways exhibiting fatigue have a low margin of safety for conduction.
    • These pathways are unlikely to be clinically significant or problematic.