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British Heart Journal logoLink to British Heart Journal
. 1985 Jul;54(1):80–85. doi: 10.1136/hrt.54.1.80

Effect of exercise on ventricular response to atrial fibrillation in Wolff-Parkinson-White syndrome.

J C Crick, D W Davies, P Holt, P V Curry, E Sowton
PMCID: PMC481853  PMID: 4015920

Abstract

Ten patients with Wolff-Parkinson-White syndrome underwent cardiac electrophysiological study extended to include the induction of atrial fibrillation at maximum exercise in the upright position. This was performed using a new temporary bipolar lead with a helical active fixation tip for atrial pacing. The highest rate of atrioventricular conduction via the accessory pathway was greater during exercise than at rest in all 10 patients (mean increase 28%). In three cases the resulting ventricular rate exceeded 300 beats/min, but no patient had severe symptoms or ventricular arrhythmias. The exercise induced enhancement of accessory pathway conduction may significantly but unpredictably affect the risk from spontaneous atrial fibrillation especially in patients with coronary artery disease or in those taking antiarrhythmic drugs. The test procedure was sufficiently simple and well tolerated to be included in our routine electrophysiological investigation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AHLINDER S., GRANATH A., HOLMER S., MASCHER G. WOLFF-PARKINSON-WHITE-SYNDROM MED PAROXYSMALT ATRIEFLIMMER OEVERGAENDE I VENTRIKELFLIMMER. FRAMGANGSRIK BEHANDLING MED EXTERN HJAERTMASSAGE OCH DEFIBRILLERING. Nord Med. 1963 Dec 12;70:1336–1339. [PubMed] [Google Scholar]
  2. AVERILL K. H., FOSMOE R. J., LAMB L. E. Electrocardiographic findings in 67,375 asymptomatic subjects. IV. Wolff-Parkinson-White syndrome. Am J Cardiol. 1960 Jul;6:108–129. doi: 10.1016/0002-9149(60)90041-2. [DOI] [PubMed] [Google Scholar]
  3. Cosio F. G., Benson D. W., Jr, Anderson R. W., Hession W. T., Pritzker M. R., Kriett J. M., Benditt D. G. Onset of atrial fibrillation during antidromic tachycardia: association with sudden cardiac arrest and ventricular fibrillation in a patient with Wolff-Parkinson-White syndrome. Am J Cardiol. 1982 Aug;50(2):353–359. doi: 10.1016/0002-9149(82)90188-6. [DOI] [PubMed] [Google Scholar]
  4. Curry P. V., Rowland E., Fox K. M., Krikler D. M. The relationship between posture, blood pressure and electrophysiological properties in patients with paroxysmal supraventricular tachycardia. Arch Mal Coeur Vaiss. 1978 Mar;71(3):293–299. [PubMed] [Google Scholar]
  5. Dreifus L. S., Haiat R., Watanabe Y., Arriaga J., Reitman N. Ventricular fibrillation. A possible mechanism of sudden death in patients and Wolff-Parkinson-White syndrome. Circulation. 1971 Apr;43(4):520–527. doi: 10.1161/01.cir.43.4.520. [DOI] [PubMed] [Google Scholar]
  6. Hammill S. C., Holmes D. R., Jr, Wood D. L., Osborn M. J., McLaran C., Sugrue D. D., Gersh B. J. Electrophysiologic testing in the upright position: improved evaluation of patients with rhythm disturbances using a tilt table. J Am Coll Cardiol. 1984 Jul;4(1):65–71. doi: 10.1016/s0735-1097(84)80320-4. [DOI] [PubMed] [Google Scholar]
  7. Horio Y., Matsuyama K., Morikami Y., Rokutanda M., Hirata A., Okumura K., Takaoka K., Uchida H., Kugiyama K., Araki S. Blocking effect of verapamil on conduction over a catecholamine-sensitive bypass tract in exercise-induced Wolff-Parkinson-White syndrome. J Am Coll Cardiol. 1984 Jul;4(1):186–191. doi: 10.1016/s0735-1097(84)80340-x. [DOI] [PubMed] [Google Scholar]
  8. Klein G. J., Bashore T. M., Sellers T. D., Pritchett E. L., Smith W. M., Gallagher J. J. Ventricular fibrillation in the Wolff-Parkinson-White syndrome. N Engl J Med. 1979 Nov 15;301(20):1080–1085. doi: 10.1056/NEJM197911153012003. [DOI] [PubMed] [Google Scholar]
  9. Przybylski J., Chiale P. A., Halpern M. S., Nau G. J., Elizari M. V., Rosenbaum M. B. Unmasking of ventricular preexcitation by vagal stimulation or isoproterenol administration. Circulation. 1980 May;61(5):1030–1037. doi: 10.1161/01.cir.61.5.1030. [DOI] [PubMed] [Google Scholar]
  10. Strasberg B., Ashley W. W., Wyndham C. R., Bauernfeind R. A., Swiryn S. P., Dhingra R. C., Rosen K. M. Treadmill exercise testing in the Wolff-Parkinson-White syndrome. Am J Cardiol. 1980 Apr;45(4):742–748. doi: 10.1016/0002-9149(80)90116-2. [DOI] [PubMed] [Google Scholar]
  11. Wellens H. J., Brugada P., Roy D., Weiss J., Bär F. W. Effect of isoproterenol on the anterograde refractory period of the accessory pathway in patients with the Wolff-Parkinson-White syndrome. Am J Cardiol. 1982 Jul;50(1):180–184. doi: 10.1016/0002-9149(82)90026-1. [DOI] [PubMed] [Google Scholar]

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