title: The natural history of Wolff-Parkinson-White syndrome in 228 military aviators: a long-term follow-up of 22 years.
abstract: BACKGROUND
  Wolff-Parkinson-White (WPW) syndrome poses a risk for tachyarrhythmias and sudden cardiac death. Most WPW studies have relatively limited numbers of subjects and brief follow-up periods.
  
  
  METHODS
  We reviewed records of 238 consecutive military aviators with WPW syndrome evaluated from 1955 to 1999. Follow-up was by questionnaires, telephone interviews, or death certificates. Events included sudden cardiac death and supraventricular tachycardia (SVT) (by electrocardiographic [ECG] documentation or suggestive symptoms).
  
  
  RESULTS
  The mean age was 34.3 years (range 17-56 years). Forty-two (42/238, 17.6%) had SVT (WPW syndrome) and 196 of 238 (82.4%) had the WPW ECG pattern only. The mean follow-up of 21.8 years (range 2-41 years) was obtained on 228 of 238 (96%) for a total of 4906 patient-years. Sudden cardiac death occurred in 1 of 228, an incidence of 0.0002 per patient-year (95% confidence interval 0.0-0.001). SVT occurred in 47 of 228 (20.6%) or 0.01 per patient-year. One hundred eighty-seven (187/228, 82%) initially had the WPW ECG pattern only; 28 of 187 (15.0%) reported SVT during follow-up. Forty-one (41/228, 18%) initially had WPW syndrome; 19 of 41(46.3%) reported additional SVT during follow-up.
  
  
  CONCLUSIONS
  Sudden cardiac death risk was low (0.02%/patient-year) in this WPW population. The SVT incidence was 1% per patient-year. Referral bias and some characteristics of the unique military aviator population may partly account for these low event rates. However, these results may be more applicable to unselected populations than are tertiary referral-based studies.
authors.affiliation: Internal Medicine Branch, Aeromedical Consultation Service, US Air Force School of Aerospace Medcine, Brooks AFB, Tex., USA.
authors.forename: P J
authors.initials: PJ
authors.lastname: Fitzsimmons
authors.forename: P D
authors.initials: PD
authors.lastname: McWhirter
authors.forename: D W
authors.initials: DW
authors.lastname: Peterson
authors.forename: W B
authors.initials: WB
authors.lastname: Kruyer
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel; D018579:Patient Selection; D013610:Tachycardia / Q000209:etiology*; D013617:Tachycardia, Supraventricular / Q000209:etiology*; D014927:Wolff-Parkinson-White Syndrome / Q000473:pathology*