Managing Asymptomatic Patients with the Wolff-Parkinson-White ECG Pattern

For patients with the Wolff-Parkinson-White (WPW) syndrome (pre-excitation plus symptomatic arrhythmias), radiofrequency catheter ablation is considered first-line therapy. In a prospective study, researchers from Italy sought to define the predictive value of electrophysiology testing (EPT) in 212 asymptomatic patients with the WPW electrocardiographic pattern.

Each patient underwent baseline EPT. Regardless of EPT results, catheter ablation was not performed, and patients were followed for development of symptoms. Follow-up EPT was conducted in 162 patients (mean age at enrollment, 33.6) a mean of 38 months after the first test.

During follow-up, 33 patients (20%) became symptomatic: 25 with supraventricular tachycardia, 8 with atrial fibri…