Studying Accessory Pathways

This chapter aims to evaluate the correlation between gender, AP location, and clinical presentation. Muscular bundles known as accessory pathways (APs) provide for quick conduction between the atria and ventricles. They can be found anywhere along the septum or groove of the atrioventricular system. The etiology of such pathways is generally unknown. This was a secondary analysis of data from the Division of Cardiac Electrophysiology, Beirut Cardiac Institute, Lebanon. All patients newly diagnosed with accessory pathways between the years 2010 and 2016 were enrolled in the study. Information extracted from the medical records included: age at the time of diagnosis, gender, characteristics, and anatomical location of the accessory pathways. A total of 139 patients with AP were enrolled in the study. The mean age of diagnosis was 32.2 ± 13.5 years. With regards to gender, APs were more common among men (p-value 0.04). Males were predominant in both the right and left AP groups (p-value 0.025), although, overall, most of the AP were left located. Also, males were more commonly diagnosed with right posteroseptal (RPS) accessory pathways while females with left lateral (LL) pathways. Concerning the clinical presentation, the manifest form was more frequent than concealed. The most prevalent accessory routes in the population under study were on the left. RPS auxiliary routes were more prevalent in men, whereas LL pathways were more abundant in females. These findings diverge from those of investigations carried out in other nations. These results provide credence to the idea that gender may play a role in the pathophysiology of accessory route development.