Analysis Of Influencing Factors Of Pre-excitation Syndrome With Atrial Fibrillation

Objective:When patients with Wolff-Parkinson-White( WPW) syndrome complicate with atrial fibrillation(AF), the rapid atrial impulse may travel via the manifest accessory pathway down to the ventricles, leading to a rapid ventricle rate or even ventricular fibrillation,causing cardiac arrest and sudden cardiac death. Our study aimed in analyzing the correlated factors in patients with pre-excitation syndrome complicated with AF and providing clinical evidence for the susceptible population of AF.Methods:Patients who underwent electrophysiological studies and radiofrequency catheter ablation from Feb 1st, 2010 to Oct 1st, 2015 in the2 nd Hospital of Jilin University were divided into two groups, with a history of AF or with no history of AF. Data of the studied patients were collected including name, gender, age, left atrial diameter, left ventricular diameter, left ventricular ejection fraction, smoking or not, drinking or not, associated diseases, and the features of the accessory pathway. AF occured during the electrophysiological studies or with a history of AF were defined as AF.Quantitative data were expressed as mean ± SD. The categorical data between the two groups are analyzed by χ2 test. T test or Wilcoxon signed rank test was used to analyze the differences in age, left atrial diameter, left ventricular diameter, left ventricular ejection fraction between the two groups. The logistic regression analysis was used to assess the relationships between AF and clinical features and the accessory pathway features. We used odds ratio(OR) with 95%confidence interval(CI) and p-values to describe the results of logistic regression. And P<0.05 was considered statistically significant.Result:There are all 538 patients, 50 patients with AF and 488 patients without AF. And AF occurs in approximately 9.29% of patients with pre-excitation syndrome. And the χ2 test showed patients with AF are more likely to be male, with a history of smoking and more likely to have manifest pathways than patients without AF. There was no significant difference in age, drinking, left atrial diameter, left ventricular diameter,left ventricular ejection fraction and the location and number of accessory pathways and associated diseases between the two groups. And the univariable logistic regression analysis showed the same results. While the multivariable logistic regression analysis showed that male and manifest pathways were independent risk factors of patients with pre-excitation syndrome complicate with AF.Conclusion:The prevalence of AF in pre-excitation syndrome is higher than normal people. The location and number of accessory pathways and age,drinking, left atrial diameter, left ventricular diameter, left ventricular ejection fraction and associated diseases are not critical in the pathogenesis of AF. However, male and manifest pathways were associated with an increased risk of AF, and smoking may be related to the occurrence of AF.