Abstract
Patients with a Wolff-Parkinson-White (WPW) pattern on their ECG can experience symptoms such as syncope, palpitations, supraventricular tachycardia, and atrial fibrillation, or they can be asymptomatic (aWPW). All patients with WPW, regardless of the presence or absence of symptoms, are at risk of sudden death. Therefore, it is recommended that younger patients with WPW undergo studies to determine their risk. We report a previously asymptomatic WPW patient identified as high risk for sudden death due to rapid conduction down her accessory pathway during atrial fibrillation induced during a trans-esophageal electrophysiology study.
Highlights
0.15% of the general population is affected with Wolff-Parkinson-White (WPW) syndrome [1]
Regardless of symptomatology, all patients with WPW are capable of rapid conduction down their accessory pathway (AP) during atrial fibrillation (A fib) which can lead to ventricular fibrillation and SCD [5]-[7]
The overall incidence of SCD in WPW patients is low, estimated at approximately 4.5 per 1000 patient-years, the catastrophic nature of this manifestation suggests an important role for risk stratification and treatment for those who are at risk [8]
Summary
0.15% of the general population is affected with Wolff-Parkinson-White (WPW) syndrome [1]. (2014) The Use of Trans-Esophageal Electrophysiology Study to Identify a High Risk Asymptomatic Wolff Parkinson White Syndrome Patient. Many patients with aWPW pattern on their ECG do not manifest symptoms and are subsequently referred to as either asymptomatic ventricular pre-excitation or asymptomatic Wolff-Parkinson-White (aWPW) [3]-[4]. Regardless of symptomatology, all patients with WPW are capable of rapid conduction down their accessory pathway (AP) during atrial fibrillation (A fib) which can lead to ventricular fibrillation and SCD [5]-[7]. We report on a previously asymptomatic WPW patient identified as high risk for SCD due to rapid conduction down her accessory pathway during A fib, shortest pre-excited RR interval of 172 msec, induced during a transesophageal electrophysiology study
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