The natural history of WPW syndrome

We report our experience on untreated WPW patients purely looking at the natural history of the disease. In a 15-year period (1995–2010), among 11 237 WPW patients referred to our Arrhythmology Department, a total of 1847 selected patients (820 symptomatic) underwent electrophysiological testing without ablation and were followed for a median (25th–75th) follow-up of 8 (5–8) years. During follow-up, malignant arrhythmias (MA) occurred in 16 patients (0.9%) of whom 14 (1.4%) were initially asymptomatic and two (0.2%) symptomatic (P = 0.01). Potentially MA developed in 143 patients (7.7%) without difference between asymptomatic and symptomatic population (P = 0.663). Benign recurrences developed in 295 patients (16%) while ventricular pre-excitation disappeared in 356 patients (19.3%) of whom 155 were initially asymptomatic. All patients were successfully ablated after arrhythmia occurrence. Patients with MA had similar accessory pathways antegrade refractory periods (AP-AERP) (P = 0.064) and more frequently inducible atrioventricular reciprocating tachycardia triggering atrial fibrillation (AVRT-AF) than those with potentially MA (P < 0.001). Symptoms did not predict MA, which were predicted by AP-AERP (HR 0.912, 95% CI 0.887–0.939, P < 0.001) and AVRT-AF (HR 8.306, 95% CI 2.269–30.405, P = 0.001). The natural history of WPW syndrome and the risk of sudden death essentially depend on intrinsic electrophysiological accessory pathway propertie...

Source: European Journal of Heart Failure Supplements - March 10, 2015 Category: Cardiology Authors: Pappone, C., Vicedomini, G., Manguso, F., Baldi, M., Petretta, A., Giannelli, L., Saviano, M., Pappone, A., Ionescu, B., Ciaccio, C., Vitale, R., Cuko, A., Calovic, Z., Fundaliotis, A., Moscatiello, M., Catalano, C., Santinelli, V. Tags: Articles Source Type: research