[Wolff-Parkinson-White, a study on the prevalence of the site of accessory pathways: relations between stability of pre-excitation, symptoms, cardiac arrhythmias and association of mitral valve prolapse with localization of pre-excitation].

The aim of this study was to evaluate the prevalence of the anatomic site of accessory pathways using surface electrocardiogram in patients affected by Wolff-Parkinson-White (WPW), and compare it to the stability of preexcitation, symptoms, incidence of arrhythmias, and the possible association of mitral valve prolapse with the localization of preexcitation. From March 1992 to August 1993 at the Cardiology Service of the Civil Hospital "Augusto Murri" in Fermo, USL 21 of the Marche Region, a total of 40 subjects suffering from WPW syndrome were examined prospectively (28 males and 12 females aged between 13 and 75 years). Using surface ECG to evaluate the axis of the delta wave in 12 standard derivations, the authors identified the anatomic site of the accessory pathways. Preexcitation stability was analysed for each patient together with the reported symptoms and the various forms of arrhythmia using dynamic ECG and effort ECG performed using a cycloergometer. Wherever possible an echocardiogram was performed to identify the possible presence of mitral valve prolapse. Out of a total of 40 patients the authors identified 3 cases with an accessory right antero-septal pathway, 13 with an anomalous postero-septal fasciculus, 11 with a right lateral and 13 with a left lateral anomaly. The statistical analysis of data revealed the stability of pre-excitation in 52.5% of cases 55% of patients were found to have a positive record with regard to past symptoms, and supraventricular or ventricular cardiac arrhythmia were diagnosed in 52.5% of the patients examined.(ABSTRACT TRUNCATED AT 250 WORDS)