title: Long term risk of Wolff-Parkinson-White pattern and syndrome.
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.
authors.affiliation: Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, 676 St. Clair, Suite 600, Chicago, IL 60611, USA; Northwestern University, Feinberg School of Medicine, 676 St. Clair, Suite 600, Chicago, IL 60611, USA. Electronic address: sukim@nm.org.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Bluhm Cardiovascular Institute, Northwestern Memorial Hospital, 676 St. Clair, Suite 600, Chicago, IL 60611, USA; Northwestern University, Feinberg School of Medicine, 676 St. Clair, Suite 600, Chicago, IL 60611, USA. Electronic address: bknight@nm.org.
authors.forename: Bradley P
authors.initials: BP
authors.lastname: Knight
mesh_terms: D000200:Action Potentials; D000293:Adolescent; D000328:Adult; D000465:Algorithms; D058070:Asymptomatic Diseases; D017115:Catheter Ablation; D002648:Child; D019091:Critical Pathways; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D057832:Watchful Waiting; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D055815:Young Adult
keywords: Asymptomatic; Atrial fibrillation; Cardiac arrest; Catheter ablation; Electrophysiology study; Sudden death; Ventricular fibrillation; Ventricular pre-excitation; WPW pattern; WPW syndrome