Long term risk of Wolff-Parkinson-White pattern and syndrome

Trends Cardiovasc Med. 2017 May;27(4):260-268. doi: 10.1016/j.tcm.2016.12.001. Epub 2016 Dec 5.

Abstract

For years, conventional wisdom has held that patients with asymptomatic ventricular pre-excitation (asymptomatic WPW or WPW pattern) were at low risk for adverse outcomes. This assumption has been challenged more recently in a number of observational/natural history studies as well as in prospective trials in which patients were more aggressively studied via invasive electrophysiology study (EPS) and more aggressively treated, in some cases, with pre-emptive catheter ablation, despite the lack of symptoms. In sum, the data do not definitively support one approach (early, up-stream EPS and/or ablation) vs. the other (watchful waiting with close monitoring). The most recent pediatric and adult guidelines reflect this ambiguity with a broad spectrum of approaches endorsed.

Keywords: Asymptomatic; Atrial fibrillation; Cardiac arrest; Catheter ablation; Electrophysiology study; Sudden death; Ventricular fibrillation; Ventricular pre-excitation; WPW pattern; WPW syndrome.

Publication types

  • Review

MeSH terms

  • Action Potentials
  • Adolescent
  • Adult
  • Algorithms
  • Asymptomatic Diseases
  • Catheter Ablation
  • Child
  • Critical Pathways
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control
  • Electrocardiography
  • Electrophysiologic Techniques, Cardiac
  • Heart Conduction System / physiopathology*
  • Heart Conduction System / surgery
  • Heart Rate
  • Humans
  • Middle Aged
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Watchful Waiting
  • Wolff-Parkinson-White Syndrome / diagnosis
  • Wolff-Parkinson-White Syndrome / etiology*
  • Wolff-Parkinson-White Syndrome / physiopathology
  • Wolff-Parkinson-White Syndrome / therapy
  • Young Adult