Comparison of Supraventricular Tachycardia from
Concealed Bypass Tract and Wolff-Parkinson-White
Syndrome
RUNGROJ KRITTAYAPHONG,M.D.*,
ONGKARN RAUNGRATANAAMPORN, M.D.**,
CHARUWAN KANGKAGATE, M.S. (Biostat) **,
ANNA CHIRAPASTAN, B.Sc.**,
SUPHACHAI CHAITHIRAPHAN, M.D., FACC**
KIERTUAI BHURIPANYO, M.D.**,
CHARN SRIRATANASATHAVORN, M.D.**,
SUKANYA POORANAWATTANAKUL, B.Sc.**,
TEIRANACH KOVITCHAROENTRAKUL, B.Sc. **,
Affiliation : * Division of Cardiology, Department of Medicine,
**Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractSupraventricular tachycardia (SVT) is a common problem. There are 2 types of accessory
atrioventricular pathway (AP) causing SVT: one can conduct antegradely (WPW syndrome) and
another can conduct only in a retrograde direction (concealed bypass tract or CBT). There are little
data of the significance and difference of the two types in Thailand. The objectives of this study
were to compare characteristics of patients, accessory pathways and outcome of radiofrequency
catheter ablation (RFCA) between the 2 types of accessory pathways. We reviewed the electrophy-
siology report of patients with supraventricular tachycardia from the accessory pathway who were
referred for RFCA. There were 74 males and 74 females at a mean age of 37 years. CBT accounts
for 44 per cent of SVT from AP. Compared to CBT, WPW syndrome was more in the right-sided
location, more associated with heart disease, a higher number of accessory pathways, more
inducible atrial fibrillation and more difficult to do ablation. However, the overall success rate of
RFCA was similar. Although the recurrence rate was 8.4 per cent, all patients with recurrence were
successfully reablated. We concluded from this study that RFCA is a highly effective method for
the treatment for both forms of accessory pathway although there are some differences between
WPW syndrome and CBT.
Keywords : Supraventricular Tachycardia, Accessory Atrioventricular Pathway, Radiofrequency Catheter Ablation
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