Wolff-Parkinson-White syndrome and antidromic atrioventricular reentrant tachycardia

This editorial refers to ‘Incidence and prognostic significance of spontaneous and inducible antidromic tachycardia’ by B. Brembilla-Perrot et al. , on page 871. The prevalence of regular paroxysmal supraventricular tachycardia (SVT) is 2.25/1000 persons and the incidence is 35/100 000 person-years, according to data from the Marshfield Epidemiologic Study Area. Thus, there are ∼570 000 patients, and 89 000 new cases/year with SVT in the US alone. In most parts of the world, atrioventricular reentrant tachycardia (AVRT), due to Wolff–Parkinson–White (WPW) syndrome or a concealed accessory pathway, is the second most common cause of SVT (after AV nodal reentrant tachycardia), and accounts for up to one-third of all SVT. In China, WPW syndrome is the most common cause of SVT, being responsible for more than 70% of cases.1 In Western countries, the prevalence of WPW syndrome is 0.1–0.3%.1 Thus, despite the fact that accessory pathways have been continually eliminated in electrophysiology laboratories during the last two decades, WPW syndrome is not likely to become extinct. Clear indications for catheter ablation in patients with WPW syndrome are not established. In patients with asymptomatic pre-excitation, the risk of sudden cardiac death is low, ∼1.25/1000 person-years.2 Symptomatic patients have …