Correlation of accessory pathway location with gender and their manifest or concealed presentation

Abstract

Background: Atrioventricular reentrant tachycardias account for approximately one third of cases referred for electrophysiological study (EPS). The anatomical substrate responsible for the reentry is an accessory pathway (AP) able to conduct the electrical stimulus in an anterograde, retrograde or bidirectional manner.

Objective: To evaluate the correlation of AP location with the male and female genders and AP clinical presentation, whether manifest or concealed.

Methods: Retrospective observational study including 942 consecutive patients, all diagnosed with EPS-confirmed AP from January 1994 to December 2008. APs were classified into eight anatomical groups: left lateral (LL), left posterior (LP), left posteroseptal (LPS), right posteroseptal (RPS), right midseptal (RMS), right anteroseptal (RAS), right lateral (RL), and right posterior (RP).

Results: Of the 942 patients, 52.6% were males. The mean age was 31.2±13.8years. As regards gender, APs were more prevalent among men. However, a statistically significant difference was observed only in the LPS (p=0.029) and RL (p=0.003) regions. In relation to the form of presentation of AP, the manifest form was more frequent than the concealed form in six of the eight regions studied, except for the LL and LPS regions.

Conclusion: AP predominated in males and the manifest form was more frequent than the concealed form in most of the regions studied.

Keywords: Accessory pathway; Concealed presentation; Manifest presentation; Wolff–Parkinson–White.