Relationship between accessory pathway location and occurrence of atrial fibrillation in patients with atrioventricular re-entrant tachycardia.

OBJECTIVE: To study the relationship between the location of atrioventricular accessory pathways and occurrence of atrial fibrillation (AF) in patients with atrioventricular re-entrant tachycardia (AVRT). METHODS: The clinical features and location of accessory pathways in patients with a history of AF were compared with those of patients with no history of AF. RESULTS: Patients with AF (n=44) were older, more likely to be male and more likely to have multiple or manifest accessory pathways than patients without AF (n=373). There was no significant difference in the location of accessory pathways between the two groups. Multivariate regression analysis showed older age, male sex, and multiple and manifest pathways were independent predictors of AF in patients with AVRT (P<0.01). CONCLUSIONS: The location of accessory pathways does not appear to play a critical role in the pathogenesis of AF in patients with AVRT. Older patients with multiple or manifest accessory pathways are at an increased risk of clinical AF.