Introduction: In the patients with Wolff-Parkinson-White (WPW) syndrome, left ventricular dyssynchrony was caused by premature ventricular activation, and it sometimes causes ventricular dysfunction; however, relation between the location of accessory pathway and brain natriuretic peptide (BNP) levels was not fully elucidated.
Method&Results: : 68 patients (48.6±19.9 years) with WPW syndrome who received a catheter ablation in our institution were studied. The patients were divided into four groups; those with manifest right or septal accessory pathway (MRS group, n=11), manifest left accessory pathway (ML group, n=24), concealed right or septal accessory pathway (CRS group, n=5), and concealed left accessory pathway (CL group, n=28). There were no differences in left atrial dimension, left ventricular dimension and left ventricular ejection fraction among these groups; however, BNP levels were significantly higher in MRS group compared to other groups (MRS group 98.9±85.7, ML group 32.8±86.8, CRS group 17.4±6.4, and CL group 37.1±51.5 pg/ml; P<0.05).
Conclusions: Anterograde conduction with right or septal accessory pathway may cause left ventricular myocardial stretch and increase BNP levels.