What question did this study set out to answer?

To review and update current evidence regarding the risk assessment and clinical management of young, asymptomatic individuals presenting with an incidental Wolff-Parkinson-White electrocardiographic pattern.

June 7, 2022Journal of Cardiology and Cardiovascular MedicineOpen Access

A Wolff-Parkinson-White (WPW) Electrocardiographic Pattern in Asymptomatic Patient – State-of-the-Art-Review

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Why the study?

A comprehensive management approach to asymptomatic patients with an incidentally discovered Wolff-Parkinson-White pattern remains debatable despite a persistent lifetime risk for fatal arrhythmias.

How should asymptomatic patients with Wolff-Parkinson-White (WPW) pattern be evaluated and managed to prevent fatal arrhythmias?

Population

Young patients and asymptomatic adults with Wolff-Parkinson-White pattern discovered incidentally on ECG

Design

Review article

Authors

VYVijay YadavTribhuvan University STSanjeev ThapaPokhara University MBManandhar BhawaniManmohan Memorial Institute of Health Sciences

Discussion

Member takes

Implication

May guide ablation decisions in asymptomatic WPW; leaves open prospective validation of thresholds.

Key Points

To review and update current evidence regarding the risk assessment and clinical management of young, asymptomatic individuals presenting with an incidental Wolff-Parkinson-White electrocardiographic pattern.
Conducted an expert state-of-the-art review synthesizing evidence on noninvasive evaluation, electrophysiological testing, and management strategies for asymptomatic Wolff-Parkinson-White patterns.
Low-risk accessory pathways are characterized noninvasively by intermittent pre-excitation on ambulatory monitoring or abrupt loss of pre-excitation during exercise stress testing.
High-risk conduction properties during electrophysiology study are identified by a shortest pre-excited RR interval (SPERRI) ≤ 250 ms during atrial fibrillation or an accessory pathway effective refractory period (APERP) ≤ 240 ms.
Shared decision-making is recommended to select candidates for catheter ablation, which offers high procedural success in preventing potential future symptomatic arrhythmias and sudden death.

Structured PICO

How should asymptomatic patients with Wolff-Parkinson-White (WPW) pattern be evaluated and managed to prevent fatal arrhythmias?

Population

Asymptomatic adults and young patients with Wolff-Parkinson-White (WPW) pattern discovered incidentally on routine electrocardiography (ECG)

Intervention

Cardiac evaluation for risk stratification (ambulatory monitoring, exercise testing, EP study) and catheter ablation

Outcome

Risk of sudden cardiac death and future symptomatic arrhythmia

Cardiac evaluation including non-invasive and invasive risk stratification is crucial in asymptomatic WPW patients to identify high-risk accessory pathways and guide shared decision-making for catheter ablation.

Cite This Study

Yadav et al. (2022) studied this question.

synapsesocial.com/papers/6a817a549adaac26113bdb5c https://doi.org/10.29328/journal.jccm.1001132

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A Wolff-Parkinson-White (WPW) Electrocardiographic Pattern in Asymptomatic Patient – State-of-the-Art-Review

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

A Wolff-Parkinson-White (WPW) Electrocardiographic Pattern in Asymptomatic Patient – State-of-the-Art-Review

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider