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Wolff-Parkinson-White Syndrome

  • Tam Dan N. Pham
  • Mark E. AlexanderEmail author
Chapter

Abstract

Wolff-Parkinson-White (WPW) syndrome is a ventricular pre-excitation syndrome affecting approximately 1–3 in 1000 individuals and carries a low, but clinically important, risk of sudden cardiac death. The clinical presentation can vary from asymptomatic WPW to cardiac arrest as the sentinel event. Practice guidelines have been developed for the management of patients with asymptomatic WPW. These guidelines include noninvasive and invasive testing and have ascribed an important role to exercise testing.

Keywords

Wolff-Parkinson-White syndrome Sudden cardiac death Exercise testing Electrocardiogram Anatomic risk Electrophysiologic risk 

References

  1. 1.
    Munger TM, Packer DL, Hammill SC, Feldman BJ, Bailey KR, Ballard DJ, et al. A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, 1953–1989. Circulation. 1993;87(3):866–73.CrossRefGoogle Scholar
  2. 2.
    Pediatric, Congenital Electrophysiology S, Heart Rhythm S, American College of Cardiology F, American Heart A, American Academy of P, et al. PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS). Heart Rhythm. 2012;9(6):1006–24.CrossRefGoogle Scholar
  3. 3.
    Cohen M, Triedman J. Guidelines for management of asymptomatic ventricular pre-excitation: brave new world or Pandora’s box? Circ Arrhythm Electrophysiol. 2014;7(2):187–9.CrossRefGoogle Scholar
  4. 4.
    Walsh EP, Triedman JK, Berul CI. Cardiac arrhythmias. In: John Keane DF, Lock J, editors. Nadas’ pediatric cardiology. 2nd ed. Philadelphia: Elsevier; 2006. p. 162–8.Google Scholar
  5. 5.
    Triedman J, Perry J, Van Hare G. Risk stratification for prophylactic ablation in asymptomatic Wolff-Parkinson-White syndrome. [comment]. N Engl J Med. 2005;352(1):92–3.CrossRefGoogle Scholar
  6. 6.
    Arruda MS, McClelland JH, Wang X, Beckman KJ, Widman LE, Gonzalez MD, et al. Development and validation of an ECG algorithm for identifying accessory pathway ablation site in Wolff-Parkinson-White syndrome. J Cardiovasc Electrophysiol. 1998;9(1):2–12.CrossRefGoogle Scholar
  7. 7.
    Kottkamp H, Hindricks G, Shenasa H, Chen X, Wichter T, Borggrefe M, et al. Variants of preexcitation--specialized atriofascicular pathways, nodofascicular pathways, and fasciculoventricular pathways: electrophysiologic findings and target sites for radiofrequency catheter ablation. J Cardiovasc Electrophysiol. 1996;7(10):916–30.CrossRefGoogle Scholar
  8. 8.
    Josephson ME. Clinical cardiac Electrophysiology. Techniques and interpretation. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 419–21.Google Scholar
  9. 9.
    Gaita F, Giustetto C, Riccardi R, Mangiardi L, Brusca A. Stress and pharmacologic tests as methods to identify patients with Wolff-Parkinson-White syndrome at risk of sudden death. Am J Cardiol. 1989;64(8):487–90.CrossRefGoogle Scholar
  10. 10.
    Bershader RS, et al. Exercise testing for risk assessment in pediatric Wolff-Parkinson-White syndrome. Heart Rhythm. 2007;4:138–9.Google Scholar
  11. 11.
    Mah DY, Sherwin ED, Alexander ME, Cecchin F, Abrams DJ, Walsh EP, et al. The electrophysiological characteristics of accessory pathways in pediatric patients with intermittent preexcitation. Pacing Clin Electrophysiol. 2013;36(9):1117–22.CrossRefGoogle Scholar
  12. 12.
    Etheridge SP, Escudero CA, Blaufox AD, Law IH, Dechert-Crooks BE, Stephenson EA, et al. Life-threatening event risk in children with Wolff-Parkinson-White syndrome: a Multicenter International Study. JACC Clin Electrophysiol. 2018;4(4):433–44.CrossRefGoogle Scholar
  13. 13.
    O’Leary ET, Dewitt ES, Mah DY, Gauvreau K, Walsh EP, Bezzerides VJ. Differentiation of fasciculoventricular fibers from anteroseptal accessory pathways using the surface electrocardiogram. Heart Rhythm. 2019. pii: S1547-5271(19)30119-5.  https://doi.org/10.1016/j.hrthm.2019.02.011.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of CardiologyBoston Children’s HospitalBostonUSA
  2. 2.Department of PediatricsHarvard Medical SchoolBostonUSA
  3. 3.Exercise Physiology, Arrhythmia Service, Department of CardiologyBoston Children’s HospitalBostonUSA

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