Electrophysiological characteristics of accessory pathways with prolonged retrograde conduction

Kuo Hung Lin, Chi Tai Kuo*, Nazar Luqman, Kuang Hung Hsu, Chiun Li Wang, Tsu Shiu Hsu, Ying Shiung Lee

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


Electrophysiological characteristics of an accessory path way (AP) with a long ventriculoatrial (VA) interval (arbitrarily defined as ≥ 50 ms and absence of continuous electrical activity) and no retrograde decremental property are described in this study. Fifteen patients (group 1) were compared with 171 patients with normal VA conduction (group 2). Mean VA conduction time was 77 ± 24 versus 34 ± 12 ms in group 1 versus group 2, respectively. Group 1 patients were older (55 ± 14 vs 40 ± 14 years), the male to female ratio was higher (2.8 vs 1.6), and APs were more prevalent on the right (60%) but manifest APs were lower (20% vs 54%) compared to group 2 patients (P < 0.05 in all cases). QRS morphology during induced atrioventricular reciprocating tachycardia was identical in both groups but the tachycardia cycle length was longer in group 1 (373 ± 29 vs 344 ± 50 ms, P < 0.05). Retrograde AP block cycle length and effective refractory period were greater in group 1 (362 ± 59 vs 293 ± 57 ms; 330 ± 58 vs 273 ± 55 ms, both P <0.05). Adenosine (up to 18 mg) and verapamil (5-10 mg) failed to block the VA conduction via AP during ventricular pacing. In group 1 the number of radiofrequency lesions for a successful ablation were significantly less (3 ± 2 vs 6 ± 5, P < 0.05). In conclusion, APs with a long VA interval and no decremental retrograde conduction have electrophysiological characteristics that are different from those with a short VA interval. Role of aging deserves further exploration.

Original languageEnglish
Pages (from-to)1250-1256
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Issue number9
StatePublished - 09 2004


  • Catheter ablation
  • Electrophysiology
  • Retrograde conduction
  • Wolff-Parkinson-White syndrome


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