title: Epidemiological profile of Wolff-Parkinson-White syndrome in a general population younger than 50 years of age in an era of radiofrequency catheter ablation.
abstract: BACKGROUND
  The prevalence of Wolff-Parkinson-White (WPW) syndrome varies between 0.68 and 1.7/1000. The epidemiological profile may be modified after the introduction of transcatheter interventions.
  
  
  OBJECTIVE
  The aim of this study is to investigate the epidemiological trends of the WPW syndrome in a general population during a period with available and reimbursed transcatheter ablation.
  
  
  RESULTS
  Data of WPW patients <50 years old were retrieved from our national database (2000-2010). We identified 6086 (61% male) patients, accounting for an overall prevalence of 0.36/1000 with a peak of 0.61/1000 in ages 20-24 years. The risk of death and sudden death was 0.071% and 0.02% per patient-year, respectively. The 42 deaths occurred at a median age of 29 years. Associated congenial heart disease was noted in 158 (2.6%) patients, including 42 with Ebstein's anomaly that increased the mortality risk (P=0.001, OR=8.5). In those without congenital heart disease, myocardial dysfunction occurred in 115 (1.9%) patients and increased the risk of death (P<0.001, OR=10.6) and sudden death. Radiofrequency catheter ablation was performed in 2527 patients at a median age of 25.7 years (4.54% per patient-year, discharge mortality 0.16%); 11 (0.4%) before the age of 5, and 2231 (88%) after the age of 15. Whereas repeated ablation procedures accounted for 6.0% of the procedures, those in Ebstein's patients were 25%.
  
  
  CONCLUSIONS
  Radiofrequency catheter ablation is already a common treatment for WPW patients, particularly during young adulthood, which accounts for a lower prevalence. Myocardial dysfunction and associated congenital heart disease remain as risks of mortality.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan.
authors.forename: Chun-Wei
authors.initials: CW
authors.lastname: Lu
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, Taiwan. Electronic address: wumh@ntu.edu.tw.
authors.forename: Mei-Hwan
authors.initials: MH
authors.lastname: Wu
authors.affiliation: Genomics Research Center, Academia Sinica, Taipei, Taiwan.
authors.forename: Hui-Chi
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Taiwan Bureau of National Health Insurance, Taipei, Taiwan.
authors.forename: Feng-Yu
authors.initials: FY
authors.lastname: Kao
authors.affiliation: Taiwan Bureau of National Health Insurance, Taipei, Taiwan.
authors.forename: San-Kuei
authors.initials: SK
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D038801:International Classification of Diseases / Q000639:trends; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D055815:Young Adult
keywords: Cardiomyopathy; Death; Epidemiology; Radiofrequency catheter ablation; Sudden death; Wolff–Parkinson–White syndrome