Radical surgical cure of Wolff-Parkinson-White syndrome: The Kanazawa experience

Abstract

Between 1973 and 1983, we operated on 160 patients with Wolff-Parkinson-White syndrome at Kanazawa University Hospital; 126 had Wolff-Parkinson-White syndrome alone, and 34 had combined cardiac diseases. Of the 160 patients, 140 were completely cured; postoperatively, they had no delta wave on electrocardiograms and no tachycardia attacks. In 11 patients, the delta wave reappeared an average of 56 days after operation. They, and three other patients with concealed Wolff-Parkinson-White syndrome, experienced several postoperative episodes of tachycardia. However, in 12 of the 14 patients with postoperative tachycardia attacks, these disappeared completely in the course of a long follow-up period and these patients are also considered to be cured symptomatically. In the two remaining patients, the tachycardia attacks persisted. Of the 126 patients with Wolff-Parkinson-White syndrome alone, none died as a direct result of the operation. Patients with combined cardiac diseases other than cardiomyopathy, mild Ebstein's anomaly, or venous abnormality were treated in one operation. Six of the 34 patients with combined cardiac diseases died. In none of the 160 patients was the His bundle intentionally interrupted as an alternative method of interrupting the accessory conduction pathway. Our study showed that life-threatening arrhythmias occur more often than expected in patients with Wolff-Parkinson-White syndrome and the tolerance for tachycardia attacks differs from patient to patient. Because the surgical treatment of Wolff-Parkinson-White syndrome is safe and reliable, as indicated in this report, the radical correction of this disease should be considered in carefully evaluated patients.