Natural History Flashcards
Ablation of WPW can improve the natural history of arrhythmias associated with WPW. There is a rarer potential benefit to ablation. What is it?
In a case report published by Jeff Kim in circulation 2014, a 4 year-old boy had significant septal dyskinesis that was corrected by ablating his paraHisian pathway, resulting in normalization of function.
Not all OT VT is benign. List some ECG indicators of a potentially more malignant phenotype of this condition.
According to a retrospective case control study published in HR 2014, VT and NSVT that accelerates over the first 4 beats is a risk factor for malignant VT. A coupling interval of < 300 ms between the first and second beat of NSVT was also a risk factor.
In a Dutch population based natural history study of repaired VSD, what percentage of patients developed symptomatic arrhythmias in a 40 year follow-up.
In a study first authored by Myrthe E. Menting in JACC 2015, symptomatic arrhythmias occurred in 13% of patients.
What is the incidence of SCD (including aborted) in asymptomatic WPW?
There is an incidence of 1.5 to 4.5 episodes of sudden death, including resuscitated SCD, per 1000 patient years. Note, this is 10-40x higher than fatalities on US highways. PACES/HRS Asymptomatic WPW consensus statement 2012
What is the risk of heart block in ccTGA?
Approximately one-tenth of infants born with congenitally corrected transposition have complete heart block [11,12]. In patients born with normal cardiac conduction, the risk of developing heart block over time increases by 2% per year until it reaches a prevalence of 10 to 15% by adolescence, and 30% in adulthood [13]. Around two-fifths of adult patients, nonetheless, will have normal cardiac conduction throughout their lives. Wallis, GA. Orphanet J Rare Dis. 2011
What percentage of conventional AV accessory pathways display decremental av conduction?
About 3%. From editorial by Benditt, DG JCE 2006
Not all patients with PVCs develop PVCic. In a study from Heart Rythm, Jan 2016, what 3 factors were shown in multivariate analysis to correlate with risk of PVCic?
- PVC burden (no specific threshold set - other studies suggest ~16-25%)
- Epicardial source of PVCs
- Lack of palpitations associated with PVCs
