Long term risk of Wolff-Parkinson-White pattern and syndrome
Introduction
In 1921, a phenomenon of “intraventricular block and a PR interval of 0.08 ms” in a 19 year-old patient with paroxysms of tachycardia was described by Wedd [1]. In 1930, Louis Wolff, MD; John Parkinson, MD; and Paul D. White, MD described a set of eleven patients with “Bundle-Branch Block with Short P-R Interval in Healthy young People Prone to Paroxysmal Tachycardia” [2]. Thus began our understanding of ventricular pre-excitation. Though a century has passed, our understanding of what is ventricular pre-excitation and the WPW syndrome is still incomplete. While ventricular pre-excitation or the WPW pattern on ECG is not uncommon with an prevalence of up to 0.1–0.3%, [3] a complete understanding of the long-term risk in patients with the WPW pattern vs. the WPW syndrome has not been reached. This review will attempt to summarize our understanding of prognosis to date and outline areas that would benefit from further clarification.
Section snippets
Terminology and pathophysiology
Two terms, the “WPW pattern” and the “WPW syndrome” are often used when describing patients with ventricular pre-excitation (Fig. 1, Panels A and B). The “WPW pattern” refers to ventricular pre-excitation seen on surface ECG while the “WPW syndrome” refers to the presence of ventricular pre-excitation on surface ECG plus the presence of symptoms suggestive of arrhythmia related to the pre-excitation, such as palpitations, episodic lightheadedness, pre-syncope, syncope, or cardiac arrest
Conclusion
The risk of cardiac arrest in patients with WPW pattern (ventricular pre-excitation without symptoms) is very low and the risk of death is even lower, with the rate of cardiac arrest ranging from 0.85 to 1.5 per 1000 patient years. This low risk must be weighed against the risk of EPS and AP ablation when contemplating management of these patients (complication rates were 3.00% in one study, including one patient with complete heart block; 4.09% when including patients with new RBBB and LBBB
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Pharmacotherapy of Wolff-Parkinson-White (WPW): A Review for Nurse Practitioners
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2022, Heart RhythmCitation Excerpt :Catheter ablation offers a potential cure for WPW syndrome, with elimination of SCD risk, though carries intrinsic procedural risks.3,4 Management of WPW syndrome must balance the risk of SCD with the risk of catheter ablation.5 A critical factor in this risk assessment is an accurate knowledge of the incidence of SCD in WPW syndrome.
Prognostic Significance and Risk of Atrial Fibrillation of Wolff-Parkinson-White Syndrome in Patients With Hypertrophic Cardiomyopathy
2018, American Journal of CardiologyCitation Excerpt :The APs were mostly located in the left free wall and septal region. A previous study documented that the APs were usually comprised of myocardial tissue.9 Mutations in PRKAG2 were reported to be associated with the incidence of WPW in patients with HC.10
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2023, Turk Kardiyoloji Dernegi ArsiviFIRST PRESENTATION OF ATRIAL FIBRILLATION WITH PRE-EXCITATION SYNDROME IN OCTOGENARIAN
2023, Journal of Arrhythmology
The authors have indicated there are no conflicts of interest.