Current approaches to diagnosis, risk stratification, and treatment of Wolff-Parkinson-White syndrome

Objective: To explore current diagnostic and risk stratification methods, as well as treatment strategies, including drug and radiofrequency ablation, in Wolff-Parkinson-White syndrome. Materials and Methods: This literature review included articles published in international databases (PubMed, Scopus, Web of Science, eLIBRARY), primarily over the past ten years, devoted to the diagnosis, risk stratification, and treatment of Wolff-Parkinson-White syndrome. Particular attention was paid to the challenges of managing patients with multiple accessory pathways and the limitations of noninvasive risk assessment methods. Results: Wolff-Parkinson-White syndrome is a congenital electrophysiological disorder caused by the presence of accessory atrioventricular connections. These abnormal pathways can cause supraventricular tachyarrhythmias, primarily atrioventricular reciprocating tachycardia, and in some cases, atrial fibrillation with a high risk of sudden cardiac death. Patients with associated congenital heart defects and genetic syndromes, for whom the risk of life-threatening arrhythmias is significantly higher, deserve special attention. Further genetic research, improved mapping and ablation methods, and the development of clinical guidelines tailored to individual risk will contribute to improved treatment outcomes for this patient population. Conclusion: Wolff-Parkinson-White syndrome is a well-studied but clinically diverse pathology that requires an individualized approach. In the century since its first description, our understanding of the disease's mechanisms has significantly improved, and the introduction of catheter ablation has radically altered the prognosis. However, unresolved issues remain: the management of asymptomatic patients, the prognostic value of non-invasive tests, and the optimal treatment strategy for multiple accessory atrioventricular connections.