Materiały źródłowe

• #1 Wolff-Parkinson-White Syndrome

  https://my.clevelandclinic.org/health/diseases/17643-wolff-parkinson-white-syndrome-wpw

  Wolff-Parkinson-White syndrome treatment varies. You might not need any treatment if you dont have symptoms often. And your symptoms may lessen and go away with time. […] If you experience rapid heartbeat frequently with symptoms like dizziness or passing out, your healthcare provider may recommend: […] Radiofrequency ablation a type of catheter ablation uses energy to destroy a small amount of heart tissue and restore a regular heartbeat. […] Cardioversion helps stop an abnormal heartbeat if you have abnormal rhythms such as SVT and restores regular heart rhythm. […] Medication (chemical cardioversion) brings your rapid heartbeat under control or keeps your heartbeat regular over time. […] Most people wont need Wolff-Parkinson-White syndrome surgery. But in some cases, healthcare providers may use open heart surgery to block your hearts extra pathway. Usually, providers use open heart surgery to treat WPW if theyre also repairing another heart condition.

• #1 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554437/

  Asymptomatic patients with WPW pattern do not require any immediate treatment. It may be beneficial for them to undergo evaluation by a cardiologist or electrophysiologist to try to determine the risk of the patient developing a tachyarrhythmia. Patients deemed to be at high risk may benefit from preventative antiarrhythmic medications or prophylactic accessory pathway ablation depending on their level of risk, the type and characteristics of the pathway, their cardiac comorbidities, and other medical conditions. In these cases, the risk of developing a dangerous arrhythmia must be weighed against the benefits and risks of medications and invasive interventions. […] The treatment of choice for symptomatic patients is an accessory pathway catheter ablation. This is commonly done by radiofrequency current ablation, but cryoablation can also be utilized. Catheter ablation has become the first-line treatment for symptomatic patients due to its high success rate and low-risk profile. The 2015 ACC/AHA/HRS guidelines utilize this as first-line therapy for symptomatic patients. Other treatment options include surgical ablation, which has a better success rate than catheter ablation and overall low mortality rate but is generally only attempted after failed catheter ablation due to the increased invasiveness of the procedure.

• #1 Wolff-Parkinson-White Syndrome (WPW) | UpBeat.org – powered by the Heart Rhythm Society

  https://upbeat.org/pediatrics/wolff-parkinson-white-syndrome-wpw

  Treatment may include medication to prevent SVT. In babies, medication is given to prevent SVT for the first year. Up to 2/3 of babies will „outgrow” WPW when diagnosed at an early age (in the first year of life) and will not require further treatment. […] Cardiac (heart) ablation has become the first line of treatment in older patients, especially in older children or adults.

• #1 Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/wolff-parkinson-white-syndrome-wpw-syndrome

  When a patient with WPW syndrome presents with a rapid, regular, narrow QRS complex tachycardia, the mechanism of the tachycardia is almost always orthodromic atrioventricular reentrant tachycardia and may be treated as any other regular, narrow QRS complex tachycardia. Vagal maneuvers are attempted first. […] If the patient is hemodynamically unstable or unresponsive to other medical therapies, synchronized DC cardioversion is used. For hemodynamically stable patients, IV adenosine is preferred. If unresponsive to IV adenosine, United States guidelines recommend a class IIb such as an IV beta blocker, IV diltiazem, or IV verapamil. […] Long-term therapy of patients who have had a documented WPW syndrome-related tachyarrhythmia (or symptoms highly suggestive thereof) is with catheter ablation of the accessory AV connection(s). A meta-analysis of ablation in WPW syndrome reports a success rate of 94%, a recurrence rate of 6% (usually treated by re-ablation), and a procedure-related complication rate of 1%.

• #1 Wolff-Parkinson-White syndrome

  https://www.nhs.uk/conditions/wolff-parkinson-white-syndrome/

  WPW syndrome can normally be completely cured. […] If your cardiologist recommends treatment, there are a number of options available. You can have treatment to either stop episodes when they occur, or prevent them occurring in the future. […] There are 3 main techniques and treatments that can help stop episodes as they occur. These are: Vagal manoeuvres techniques designed to stimulate the nerve that slows down the electrical signals in your heart. An example is the „Valsalva manoeuvre”, where you hold your nose, close your mouth and exhale hard while straining as if you’re on the toilet. […] Medication an injection of medicine such as adenosine can be given in hospital if vagal manoeuvres don’t help. It can block the abnormal electrical signals in your heart. […] Cardioversion a type of electric shock therapy that jolts the heart back into a normal rhythm. This may be carried out in hospital if the above treatments don’t work.

• #1 Wolff-Parkinson-White (WPW) syndrome | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/wolff-parkinson-white-wpw-syndrome?content_id=CON-20206635

  Treatment of WPW syndrome may include special actions, medicines, a shock to the heart or a procedure to stop the irregular heartbeats. […] The goals of WPW syndrome treatment are to: Slow a fast heart rate when it occurs. Prevent future episodes. […] Treatment options may include: Vagal maneuvers. These are simple actions that can slow the heartbeat. They include coughing, bearing down as if passing stool and putting an ice pack on the face. Your healthcare team may ask you to do these specific actions during an episode of a fast heartbeat. These actions affect the vagus nerve, which helps control the heartbeat. […] Medicines. If vagal maneuvers don’t stop a fast heartbeat, you might need medicines to control the heart rate and restore the heart rhythm. Medicines may need to be given by IV.

• #1 Wolff-Parkinson-White (WPW) Syndrome | CommonSpirit Health

  https://www.commonspirit.org/conditions-treatments/wolff-parkinson-white-wpw-syndrome

  During an episode of Wolff-Parkinson-White syndrome (WPW), your doctor may suggest that you try vagal maneuvers. These are things that might help slow your heart rate. Your doctor will teach you how to do vagal maneuvers safely. Examples include bearing down or putting an ice-cold, wet towel on your face. […] If an episode needs emergency treatment, you might have a procedure called electrical cardioversion to reset your heart rhythm. Or you may get a fast-acting medicine to slow your heart rate. […] The goals of long-term treatment are to prevent episodes, relieve symptoms, and prevent future problems. You and your doctor can decide what type of treatment is right for you. Your options may include medicines or a procedure called catheter ablation.

• #1 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554437/

  The pharmacologic treatment of choice for antidromic AVRT is procainamide. In the setting of preexcitation and atrial fibrillation, AV nodal blockade is contraindicated. Procainamide and ibutilide are agents of choice in atrial fibrillation with preexcitation on ECG. Amiodarone has been used in WPW pattern with atrial fibrillation, but some evidence suggests that it is less effective and has a higher risk of precipitating ventricular fibrillation. […] Patients with WPW pattern on ECG who present with hemodynamically stability, orthodromic AVRT will demonstrate a regular narrow complex tachycardia. They can be managed similarly to other regular narrow complex supraventricular tachycardias. Vagal maneuvers followed by a trial of adenosine are the first-line therapy. The 2015 ACC/AHA/HRS guidelines recommend beta-blockers or calcium channel blockers as the second-line agents with electric cardioversion being reserved for refractory arrhythmias.

• #1 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554437/

  The 2015 ACC/AHA/HRS guidelines indicate that in asymptomatic patients with WPW pattern, EP study is reasonable, and ablation is reasonable for accessory pathways found to be either at high risk or in patients with high-risk occupations. […] For patients that this is not an option or preference, antiarrhythmic medications can be a reasonable alternative option. […] According to the ACLS tachycardia algorithm, patients with persisting tachyarrhythmia who are deemed hemodynamically unstable as determined by identification of hypotension, acutely altered mental status, signs of shock, ischemic chest discomfort, or acute heart failure should undergo synchronized cardioversion or defibrillation. […] AV nodal blockade can induce this scenario if given in the setting of a bystander accessory pathway and rapid atrial rhythm, as seen in atrial fibrillation, atrial flutter, or other atrial tachycardias.

• #1 Atrial Fibrillation and Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/atrial-fibrillation-and-wolff-parkinson-white-syndrome-wpw-syndrome

  The treatment of choice for Wolff-Parkinson-White syndrome with atrial fibrillation is direct current cardioversion (1). The usual rate-slowing medications used in atrial fibrillation are not effective, and digoxin, adenosine, and the nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) that may be used in many other forms of supraventricular tachycardia are contraindicated because they may increase the ventricular rate and cause ventricular fibrillation. […] If cardioversion is impossible, medications that prolong the refractory period of the accessory connection should be used. IV procainamide or ibutilide is preferred (1), but any class Ia, class Ic, or class III antiarrhythmic medication can be used. […] Do not give digoxin, adenosine, or nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) to patients with atrial fibrillation and Wolff-Parkinson-White syndrome because these medications may trigger ventricular fibrillation.

• #1 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  RF ablation is indicated in the following patients: Patients with symptomatic atrioventricular reentrant tachycardia (AVRT); Patients with AF or other atrial tachyarrhythmias that have rapid ventricular response via an AP (preexcited AF); Patients with AVRT or AF with rapid ventricular rates found incidentally during EPS for unrelated dysrhythmia, if the shortest preexcited RR interval during AF is less than 250 ms; Asymptomatic patients with ventricular preexcitation whose livelihood, profession, insurability, or mental well-being may be influenced by unpredictable tachyarrhythmias or in whom such tachyarrhythmias would endanger the public safety; Patients with WPW and a family history of SCD. […] Symptomatic individuals with orthodromic tachycardia should undergo risk assessment and should be offered therapy according to their symptoms. RF ablation can be curative and carried out with a high degree of success, a low complication rate, and a low recurrence rate.

• #1 WPW syndrome: Rare cause of sudden cardiac death in young people – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/wolff-parkinson-white-syndrome/diagnosis-treatment/drc-20354630

  Cardiac catheter ablation […] In catheter ablation, one or more thin, flexible tubes called catheters are passed through a blood vessel and guided to the heart. Sensors on the catheter tips use heat or extreme cold to scar a small area of heart tissue. The scarring blocks faulty electrical signals that cause an irregular heartbeat. […] Treatment for Wolff-Parkinson-White (WPW) syndrome depends on: […] The goals of WPW syndrome treatment are to: […] Treatment options may include: […] Catheter ablation. In this procedure, a doctor inserts one or more thin, flexible tubes called catheters into an artery, usually in the groin. The doctor guides them to the heart. Sensors on the tip of the catheters use heat or cold energy to create tiny scars in the heart. The scars block irregular electrical signals and restore the heart’s rhythm. Catheter ablation may be done at the same time as other heart surgeries.

• #1 Wolff–Parkinson–White syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Wolff%E2%80%93Parkinson%E2%80%93White_syndrome

  WPW syndrome may be monitored or treated with either medications or an ablation (destroying the tissues) such as with radiofrequency catheter ablation. […] According to the ACLS protocol, people with WPW who are experiencing rapid abnormal heart rhythms (tachydysrhythmias) may require synchronized electrical cardioversion if they are demonstrating severe signs or symptoms (for example, low blood pressure or lethargy with altered mental status). If they are relatively stable, medication may be used. […] WPW pattern with hemodynamically stability and orthodromic AVRT leading to a regular narrow complex tachycardia may be managed similarly to other regular narrow complex supraventricular tachycardias: first with vagal maneuvers followed by a trial of adenosine (first-line therapy). […] The definitive treatment of WPW is the destruction of the abnormal electrical pathway by catheter ablation. Two main types of catheter ablation include radiofrequency ablation with heat or cryoablation with cold energy.

• #1 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  The two main treatment approaches to WPW syndrome are (1) pharmacotherapy and (2) EPS with RF catheter ablation. EPS with ablation is the first-line treatment for symptomatic WPW syndrome and for patients with high-risk occupations. It has replaced surgical treatment and most drug treatments. RF ablation used in conjunction with cryoablation for septal APs and APs near small coronary arteries has had high success rates with low risk. […] Drug therapy can be useful in some instances, such as in patients who refuse RF ablation and in temporizing patients with a higher risk of ablation-related complications (eg, AV block with pacing requirement for anteroseptal or midseptal pathways). Medical therapy may also be appropriate in pregnant women until radiation exposure is safe. […] In choosing drug therapy, keep in mind that class Ic and class III antiarrhythmic medications will slow AP conduction, facilitating blockage of SVT. If the patient has a history of AF or atrial flutter, an AV nodal blocking medication should also be used.

• #1 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics

  If a person is unstable due to low blood pressure (due to the rapid heart rate) or if the medication is not immediately effective, electrical cardioversion can be used to stop the arrhythmia. In cardioversion, electricity is discharged into the heart from pads or paddles placed on the chest. The current affects the electrical charge of the heart muscle cells to restart a normal rhythm. […] Preventing recurrence of the tachycardia — There are three major options for preventing recurrence of the tachycardia: radiofrequency ablation, medications, and surgery. The choice is best made with a heart rhythm specialist (cardiac electrophysiologist) who has experience in treating the WPW syndrome. […] Radiofrequency ablation — Radiofrequency catheter ablation of the accessory pathway is the treatment of choice for people with WPW syndrome. Radiofrequency ablation procedures are performed in a hospital electrophysiology lab using X-ray equipment and can take two to three hours to complete. The person is given a sedative medication to reduce discomfort.

• #1 Wolff-Parkinson-White syndrome (WPW): MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000151.htm

  Medicines, particularly antiarrhythmic drugs such as procainamide or amiodarone, may be used to control or prevent a rapid heartbeat. […] If the heart rate does not return to normal with medical treatment, health care providers may use a type of therapy called electrical cardioversion (shock). […] The long-term treatment for WPW syndrome is very often catheter ablation. This procedure involves inserting a tube (catheter) into a vein through a small cut near the groin up to the heart area. When the tip reaches the heart, the small area that is causing the fast heart rate is destroyed using a special type of energy called radiofrequency or by freezing it (cryoablation). This is done as part of an electrophysiologic study (EPS). […] Open heart surgery to burn or freeze the extra pathway may also provide a permanent cure for WPW syndrome. In most cases, this procedure is done only if you need heart surgery for other reasons. […] Catheter ablation cures this disorder in most people. The success rate for the procedure ranges between 85% to 95%. Success rates will vary depending on the location and number of extra pathways.

• #1 Wolff–Parkinson–White syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Wolff%E2%80%93Parkinson%E2%80%93White_syndrome

  Findings from 1994 indicate success rates of as high as 95% in people treated with radiofrequency catheter ablation for WPW. […] If radiofrequency catheter ablation is successfully performed, the condition is generally considered cured. Recurrence rates are typically less than 5% after a successful ablation.

• #1 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics

  A wire (electrode catheter) is advanced into the heart from large blood vessels and positioned within the chambers of the heart using fluoroscopy (low energy x-rays). After the accessory pathway is localized, radiofrequency energy (high frequency electricity) is delivered to the area to destroy or „ablate” the accessory pathway, preventing it from conducting impulses. […] When performed by experienced specialists, ablation cures the WPW syndrome over 95 percent of the time. Some people have multiple accessory pathways that need to be ablated. Occasionally, the accessory pathway can recover from the ablation, and the ablation procedure needs to be repeated. […] The risk of a major complication is low, approximately 3 percent, with the primary risks being damage to the blood vessels or nerves in the thigh, bleeding, infection, perforation of the heart, and heart block requiring a pacemaker. The risk of specific complications depends in part on the location of the accessory pathway and which critical structures are nearby.

• #1 Wolff Parkinson White Syndrome – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/wolff-parkinson-white-syndrome/

  In the case of long-term oral medication, it is recommended to use drugs that impede conduction through accessory pathways (e.g. class IA, IC or III agents). Sodium channel blockers (class IA and IC antiarrhythmics) and certain class III antiarrhythmic medications are particularly effective in slowing down conduction as well as prolonging the refractory period of accessory pathways and atrioventricular node; thus, they are considered optimal for this particular condition. […] Digitalis, beta blockers, and calcium channel blockers are effective in inhibiting conduction through the AV node; however, they do not impede conduction over most accessory pathways. On the contrary, these drugs may actually reduce the refractory period of an accessory pathway which could lead to a faster ventricular rate (and a risk of hemodynamic collapse) if administered to individuals suffering from WPW syndrome who experience atrial flutter.

• #1 Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/wolff-parkinson-white-syndrome-wpw-syndrome

  If ablation cannot be performed or if the patient declines ablation, medical therapy may be accomplished with almost any oral antiarrhythmic medication other than digoxin. Class IIa recommendations are given for oral flecainide or oral propafenone in the absence of a structural heart disorder. Class IIb recommendations are given for oral dofetilide, oral sotalol, and oral amiodarone. […] Although a class IIb recommendation is given for oral beta blockers (especially useful if symptoms occur with exercise), oral diltiazem, or oral verapamil, there is a small possibility that these mediations could be harmful should atrial fibrillation ever occur.

• #1 Wolff-Parkinson-White (WPW) Syndrome | Doctor

  https://patient.info/doctor/wolff-parkinson-white-syndrome-pro

  Patients who present with tachyarrhythmic symptoms may require drug therapy to prevent further episodes and while awaiting definitive treatment – this may also be a long-term option for those in whom ablation or surgery are contraindicated, or not wanted. […] Digoxin is contra-indicated in patients with WPW syndrome. Most deaths from WPW syndrome have been associated with digoxin use. […] RF ablation is increasingly being used both in common types of arrhythmia and selected asymptomatic patients, with a 95% success rate. […] This is now first-line management, ahead of open-heart surgical disconnection and cardiac pacing. […] Indications for RF ablation include: Patients with symptomatic AV re-entrant tachycardia. […] Surgical ablation may still be indicated for patients in whom RF ablation has failed, those who need heart surgery for other reasons and for those patients with multifocal abnormalities requiring surgical ablation (rare).

• #1 Surgical treatment of Wolff-Parkinson-White syndrome: Resuscitation of a forgotten technique

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10267807/

  This article describes, in detail, the techniques of surgical ablation for Wolff-Parkinson-White syndrome. Surgery is now rarely performed for this indication but may be necessary in refractory cases. […] In most patients, catheter ablation will provide a cure for WPW; however, in select, refractory cases there is still a role for surgical intervention. […] The procedure was performed through a median sternotomy under cardiopulmonary bypass but without cardioplegic arrest. […] This surgical technique report is presented to demonstrate the need for knowledge of surgical technique to appropriately care for rare patients who require surgical ablation for WPW.

• #1 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics

  Surgery — Surgery is another method to disconnect the WPW pathway. The success rate for surgical ablation is close to 100 percent and the complication rate is low. However, radiofrequency ablation is a less invasive option; as a result, surgery is now rarely performed. Surgical ablation may be preferred if the person is undergoing cardiac surgery for other reasons (such as coronary artery bypass surgery or valve surgery) and is recommended when radiofrequency ablation and medications are not effective. […] Medications — Medications can prevent recurrences of tachycardia in some people with WPW, but they are usually used only in people who are not candidates for ablation or surgery. These people may be given medications to use during an episode or to take daily to prevent the arrhythmia. They may also be taught to perform maneuvers (eg, Valsalva) that can stop the tachycardia.

• #1 Get Wolff-Parkinson-White Syndrome Treatment | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/wolff-parkinson-white-syndrome-treatment

  Your child may not need treatment, especially if they don’t have ongoing symptoms. But if they have a constantly rapid heart rate and dizziness, fainting and shortness of breath their provider may recommend one or a combination of treatments, like: […] If your child is old enough (and their providers feel this treatment is right for them), we’ll teach them to use vagal maneuvers. These can activate the vagus nerve to help slow their heart rate: […] Your child’s care team may recommend cardioversion to get their heart back to beating at a normal rhythm. Chemical cardioversion uses medications given as a pill or through an IV (in a vein in their arm) to slow their heart rate. Electrical cardioversion uses a device to send a shock to their heart when they need it. […] Our pediatric cardiology experts use catheter ablation, a type of ablation therapy, to „destroy” the abnormal pathway. Either heat (radiofrequency ablation) or cold (cryoablation) can help disrupt the electrical signals causing irregular heartbeats.

• #1 Wolff-Parkinson-White (WPW) Syndrome – Heart and Blood Vessel Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/heart-and-blood-vessel-disorders/abnormal-heart-rhythms/wolff-parkinson-white-wpw-syndrome

  Episodes of paroxysmal supraventricular tachycardia due to Wolff-Parkinson-White syndrome can often be stopped by one of several maneuvers that stimulate the vagus nerve and thus slow the heart rate. Maneuvers include […] When these maneuvers are ineffective, medications such as verapamil, diltiazem, or adenosine are usually given intravenously to stop the arrhythmia. Antiarrhythmic medications may then be continued indefinitely to prevent episodes of a fast heart rate […] In infants and children younger than 10 years, digoxin may be given to suppress episodes of paroxysmal supraventricular tachycardia due to Wolff-Parkinson-White syndrome. However, adults with the syndrome should not take digoxin because it can facilitate conduction by the extra pathway and increase the risk that atrial fibrillation will degenerate into ventricular fibrillation.

• #1 Wolff-Parkinson-White syndrome | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/wolff-parkinson-white-syndrome

  Wolff-Parkinson-White syndrome is characterised by attacks of rapid heart rate (tachycardia). […] Treatment options include medication, a heart catheter procedure, the implantation of a pacemaker, or surgery to eliminate the extra pathway. […] The treatment options for Wolff-Parkinson-White syndrome depend on the severity, but can include: […] Anti-arrhythmic drugs to slow the heart rate or to prevent attacks. […] Electric cardioversion (shock) to stop a tachycardia attack. […] An electrophysiology study to locate the site of the extra pathway and eliminate it, using a short treatment with radio frequency energy, applied through a catheter. […] An artificial pacemaker to help regulate the heart rate. […] Open-heart surgery to eliminate the extra pathway. […] Removing the extra pathway, via catheterisation, usually cures the disorder. This can be done effectively in most patients after the age of about 7 years. […] If it cannot be found or eliminated safely then long-term medication may be necessary or surgery might be recommended.

• #1 Wolff-Parkinson-White Syndrome – Seattle Children’s

  https://www.seattlechildrens.org/conditions/wolff-parkinson-white-syndrome/

  Now, doctors sometimes use cryoablation. This method destroys the tissue by freezing it. This newer technique may be safer. It also seems that the heart tissue is able to recover better after cryoablation. Talk with your heart doctor about which method is best for your child. […] We offer a full range of diagnostic procedures and treatments. Along with using heart medicines, we have deep experience with radiofrequency ablation and cryoablation procedures in children who need them to correct an abnormal heart rhythm. […] Doctors at Seattle Childrens are working to advance treatment for WPW and enhance the quality of life for children with this condition. […] We were the first institution in the region to routinely offer cryoablation for children, greatly increasing the safety of ablation for arrhythmia. […] Seattle Childrens is one of the few institutions in the region to offer zero fluoro or minimal fluoro ablation. This means we use techniques many that we developed to expose your child to little or no X-ray radiation. Most places use fluoroscopy during ablation.

• #1 Wolff-Parkinson-White Syndrome – Seattle Children’s

  https://www.seattlechildrens.org/conditions/wolff-parkinson-white-syndrome/

  Children with WPW do not always need treatment. Often, an irregular heartbeat does not cause any problems. But sometimes it keeps the heart from pumping the right amount of blood to the brain or other organs. This can be dangerous. So, it is important to have your childs heart checked by a doctor who can offer treatment if your child needs it. […] Your child may need treatment if they have symptoms or they have a fast heartbeat that happens often or lasts for a while. Doctors treat WPW first with medicines that control the heart rate. […] If medicine does not work well enough, doctors may use ablation. They may also use ablation to get rid of an abnormal electrical pathway if it poses a dangerous risk to your child. […] Ablation is a procedure that uses a thin plastic tube (catheter) to destroy the tissue that causes the rapid heartbeat. Traditionally, doctors did this with a catheter that used radiofrequency energy to burn (cauterize) the abnormal tissue.

• #1 WOLFF-PARKINSON-WHITE DISORDER | Sports Medicine Today

  https://www.sportsmedtoday.com/wolffparkinsonwhite-disorder-va-266.htm

  WPW is diagnosed by looking at the hearts electrical activity with an electrocardiogram (ECG or EKG). […] If WPW is diagnosed, the patient will need to see a cardiologist to identify the type and speed of the abnormal electrical pathway. If treatment is needed, the cardiologist will consider a procedure called a catheter ablation. This gets rid of the extra electrical pathway, which can cure the disorder. […] If the athlete has symptoms, has a high-risk pathway, or participates in high-risk sports, then the athlete needs to see a cardiologist to consider an ablation. After the procedure, if there are no symptoms and there is a normal ECG, an athlete can consider returning to play.

• #1 Get Wolff-Parkinson-White Syndrome Treatment | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/wolff-parkinson-white-syndrome-treatment

  Treatment like radiofrequency ablation often solves the problem. If not, your child’s provider may recommend managing symptoms with vagal maneuvers, and/or medications. If your child doesn’t have symptoms, we may recommend watchful management, where we keep a close eye on your child with regular appointments. If new symptoms come up or existing ones get worse, we can treat them quickly. […] Arrhythmias caused by Wolff-Parkinson-White syndrome are treatable. And the pediatric cardiology providers at Cleveland Clinic Childrens are here to help. We’ll work with you and your child to pinpoint what’s causing their too-fast heart rate. And we’ll build the best treatment plan for their needs.

• #1 Wolff-Parkinson-White Syndrome: Symptoms, Treatment, More

  https://www.healthline.com/health/arrhythmia/wolff-parkinson-white-syndrome

  WPW syndrome is a common cause of a type of heart arrhythmia called paroxysmal supraventricular tachycardia. Its a type of fast heart rhythm that comes and goes. […] Asymptomatic WPW syndrome doesnt necessarily require treatment, but you will need to visit a doctor for regular checkups. […] However, if you do have symptoms, a doctor may recommend certain treatments based on the severity and frequency of your symptoms. […] Some treatments and lifestyle changes may help prevent future WPW syndrome episodes. These include: undergoing catheter ablation, a potentially curative procedure and the most common treatment for WPW syndrome, works to destroy the extra heart muscle fiber; taking antiarrhythmic drugs, such as amiodarone (Pacerone, Nexterone), procainamide (Pronestyl), sotalol (Betapace, Sorine), dofetilide (Tikosyn); avoiding high amounts of caffeine or alcohol; making exercise modifications, as more strenuous workouts can contribute to WPW syndrome symptoms; managing stress.

• #1 Wolff-Parkinson-White syndrome

  https://www.nhs.uk/conditions/wolff-parkinson-white-syndrome/

  Techniques and treatments that can help prevent episodes include: Lifestyle changes if your episodes are triggered by things such as strenuous exercise or alcohol, avoiding these may help. Your cardiologist can advise you about this. […] Catheter ablation this procedure is commonly used nowadays to destroy the extra part of the heart causing the problems in the heart’s electrical system. It’s effective in around 95% of cases. […] Medication daily tablets of medication such as amiodarone can help prevent episodes by slowing down the electrical impulses in your heart.

• #1 Wolff-Parkinson-White Syndrome

  https://my.clevelandclinic.org/health/diseases/17643-wolff-parkinson-white-syndrome-wpw

  While radiofrequency ablation is a safe and effective procedure, people who have catheter ablation can get: […] Complications from cardioversion are rare, too. Some people can get blood clots, injury to their skin from the procedure or a worsening arrhythmia. […] Your provider can tell you when symptoms should improve after ablation or surgery for WPW. They can also tell you what to expect during recovery and when you can return to daily activities. […] People who receive treatment for Wolff-Parkinson-White syndrome have a typical life expectancy. Radiofrequency ablation or surgery can cure WPW in many people.

• #2 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  Treatment of Wolff-Parkinson-White (WPW)-associated arrhythmias is directed at the underlying cause (through the use of radiofrequency [RF] ablation of the accessory pathway [AP], antiarrhythmic drugs in adults to slow AP conduction in certain situations (ie, Mahaim or atriofascicular pathway-mediated supraventricular tachycardia [SVT]; typically, atrioventricular [AV] nodal-conduction blocking medications are avoided in the acute setting of WPW), or AV nodal blocking medications to slow AV nodal conduction. […] For adult patients, treatment also addresses the triggers that perpetuate the dysrhythmia, which include coronary heart disease, ischemia, cardiomyopathy, pericarditis, electrolyte disturbances, thyroid disease, and anemia. […] Treatment must be individualized for each patient and should include individual risk assessment. Appropriate therapy for WPW syndrome is based on the likely prognosis and on the degree of symptoms the patient experiences. Specific subspecialty consultations are often needed and may include a cardiovascular specialist (adult or pediatric cardiologist) and/or an electrophysiologist (arrhythmia specialist) with expertise in invasive studies.

• #2 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554437/

  The 2015 ACC/AHA/HRS guidelines indicate that in asymptomatic patients with WPW pattern, EP study is reasonable, and ablation is reasonable for accessory pathways found to be either at high risk or in patients with high-risk occupations. […] For patients that this is not an option or preference, antiarrhythmic medications can be a reasonable alternative option. […] According to the ACLS tachycardia algorithm, patients with persisting tachyarrhythmia who are deemed hemodynamically unstable as determined by identification of hypotension, acutely altered mental status, signs of shock, ischemic chest discomfort, or acute heart failure should undergo synchronized cardioversion or defibrillation. […] AV nodal blockade can induce this scenario if given in the setting of a bystander accessory pathway and rapid atrial rhythm, as seen in atrial fibrillation, atrial flutter, or other atrial tachycardias.

• #2 Wolff-Parkinson-White Syndrome

  https://my.clevelandclinic.org/health/diseases/17643-wolff-parkinson-white-syndrome-wpw

  Wolff-Parkinson-White syndrome treatment varies. You might not need any treatment if you dont have symptoms often. And your symptoms may lessen and go away with time. […] If you experience rapid heartbeat frequently with symptoms like dizziness or passing out, your healthcare provider may recommend: […] Radiofrequency ablation a type of catheter ablation uses energy to destroy a small amount of heart tissue and restore a regular heartbeat. […] Cardioversion helps stop an abnormal heartbeat if you have abnormal rhythms such as SVT and restores regular heart rhythm. […] Medication (chemical cardioversion) brings your rapid heartbeat under control or keeps your heartbeat regular over time. […] Most people wont need Wolff-Parkinson-White syndrome surgery. But in some cases, healthcare providers may use open heart surgery to block your hearts extra pathway. Usually, providers use open heart surgery to treat WPW if theyre also repairing another heart condition.

• #2 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554437/

  Asymptomatic patients with WPW pattern do not require any immediate treatment. It may be beneficial for them to undergo evaluation by a cardiologist or electrophysiologist to try to determine the risk of the patient developing a tachyarrhythmia. Patients deemed to be at high risk may benefit from preventative antiarrhythmic medications or prophylactic accessory pathway ablation depending on their level of risk, the type and characteristics of the pathway, their cardiac comorbidities, and other medical conditions. In these cases, the risk of developing a dangerous arrhythmia must be weighed against the benefits and risks of medications and invasive interventions. […] The treatment of choice for symptomatic patients is an accessory pathway catheter ablation. This is commonly done by radiofrequency current ablation, but cryoablation can also be utilized. Catheter ablation has become the first-line treatment for symptomatic patients due to its high success rate and low-risk profile. The 2015 ACC/AHA/HRS guidelines utilize this as first-line therapy for symptomatic patients. Other treatment options include surgical ablation, which has a better success rate than catheter ablation and overall low mortality rate but is generally only attempted after failed catheter ablation due to the increased invasiveness of the procedure.

• #2 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics

  Stopping the tachycardia — When the tachycardia is an atrioventricular reentrant tachycardia (AVRT), the tachycardia can often be stopped by interfering with the circular loop described above. […] This can be achieved by two simple maneuvers: […] – Coughing or bearing down as if having a bowel movement (called the Valsalva maneuver) […] – Firmly massaging the main artery in the person’s neck (called carotid sinus pressure) […] If these measures are not effective, medications may be used to stop the tachycardia. The best medication depends upon the mechanism that is responsible. In most cases, the person must go to an emergency department to receive intravenous (IV) medications to stop the abnormal rhythm. A heart specialist (cardiologist) with experience in the treatment of rhythm disturbances often assists with treatment in this case.

• #2 Wolff-Parkinson-White Syndrome (WPW) – Symptoms, Tests & Treatments – BHF

  https://www.bhf.org.uk/informationsupport/conditions/wolff-parkinson-white-syndrome

  WPW is treated based on your symptoms. […] The priority is to stop the tachycardia and return the heart rate and rhythm back to normal. There are a few ways that this can be treated: Vagal manoeuvres these are different techniques to help get your heart rate back to normal. They stimulate nerves that slow down your hearts electrical messages. Your doctor will teach you the techniques and let you what ones will be best for you. […] Medication if vagal manoeuvres dont work, you might be given an injection of some medicine to block the extra electrical signals in your heart. This will make your hearts electrical messages travel through the normal path and set your heartbeat back to normal. […] Cardioversion – this sets your heart rhythm back to a normal pattern by sending controlled electrical signals to your heart. Your specialist will then offer treatment to avoid this from happening again.

• #2 Atrial Fibrillation and Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/atrial-fibrillation-and-wolff-parkinson-white-syndrome-wpw-syndrome

  The treatment of choice for Wolff-Parkinson-White syndrome with atrial fibrillation is direct current cardioversion (1). The usual rate-slowing medications used in atrial fibrillation are not effective, and digoxin, adenosine, and the nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) that may be used in many other forms of supraventricular tachycardia are contraindicated because they may increase the ventricular rate and cause ventricular fibrillation. […] If cardioversion is impossible, medications that prolong the refractory period of the accessory connection should be used. IV procainamide or ibutilide is preferred (1), but any class Ia, class Ic, or class III antiarrhythmic medication can be used. […] Do not give digoxin, adenosine, or nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) to patients with atrial fibrillation and Wolff-Parkinson-White syndrome because these medications may trigger ventricular fibrillation.

• #2 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554437/

  The pharmacologic treatment of choice for antidromic AVRT is procainamide. In the setting of preexcitation and atrial fibrillation, AV nodal blockade is contraindicated. Procainamide and ibutilide are agents of choice in atrial fibrillation with preexcitation on ECG. Amiodarone has been used in WPW pattern with atrial fibrillation, but some evidence suggests that it is less effective and has a higher risk of precipitating ventricular fibrillation. […] Patients with WPW pattern on ECG who present with hemodynamically stability, orthodromic AVRT will demonstrate a regular narrow complex tachycardia. They can be managed similarly to other regular narrow complex supraventricular tachycardias. Vagal maneuvers followed by a trial of adenosine are the first-line therapy. The 2015 ACC/AHA/HRS guidelines recommend beta-blockers or calcium channel blockers as the second-line agents with electric cardioversion being reserved for refractory arrhythmias.

• #2 Treatment of arrhythmias associated with the Wolff-Parkinson-White syndrome – UpToDate

  https://www.uptodate.com/contents/treatment-of-arrhythmias-associated-with-the-wolff-parkinson-white-syndrome

  Treatment of arrhythmias associated with the Wolff-Parkinson-White syndrome […] This topic will review the available therapeutic options for the treatment and prevention of arrhythmias in WPW syndrome. […] Patients who present with an acute arrhythmia require pharmacologic therapy for restoration of sinus rhythm. […] Unstable patients should undergo urgent electrical cardioversion. […] Stable patients should be evaluated to determine the type of arrhythmia present. […] Catheter ablation as initial therapy is recommended for the prevention of recurrent arrhythmias. […] Alternative therapy includes antiarrhythmic drugs. […] Therapy for recurrence may involve repeat catheter ablation and surgical ablation.

• #2 A Case of Supraventricular Tachycardia Associated With Wolff-Parkinson-White Syndrome | Chee | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/2693/2318

  Unstable patient with WPW syndrome related atrial fibrillation is best managed with synchronized cardioversion. […] Medications with significant AV nodal blocking effects should be avoided in all instances. […] Adenosine is widely used in an acute care setting and is generally considered to be safe and effective diagnostic and therapeutic agent. […] This case also highlights the importance of following up patients following successful management of arrhythmia/SVT.

• #2 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  The two main treatment approaches to WPW syndrome are (1) pharmacotherapy and (2) EPS with RF catheter ablation. EPS with ablation is the first-line treatment for symptomatic WPW syndrome and for patients with high-risk occupations. It has replaced surgical treatment and most drug treatments. RF ablation used in conjunction with cryoablation for septal APs and APs near small coronary arteries has had high success rates with low risk. […] Drug therapy can be useful in some instances, such as in patients who refuse RF ablation and in temporizing patients with a higher risk of ablation-related complications (eg, AV block with pacing requirement for anteroseptal or midseptal pathways). Medical therapy may also be appropriate in pregnant women until radiation exposure is safe. […] In choosing drug therapy, keep in mind that class Ic and class III antiarrhythmic medications will slow AP conduction, facilitating blockage of SVT. If the patient has a history of AF or atrial flutter, an AV nodal blocking medication should also be used.

• #2 Wolff-Parkinson-White syndrome – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/400

  Wolff-Parkinson-White (WPW) syndrome occurs when myocardial fibres connect the atrium to the ipsilateral ventricle across the mitral or tricuspid annulus (accessory pathway), pre-exciting the ventricle. […] Asymptomatic patients can either be monitored or screened to determine whether they have a 'high-risk’ accessory pathway, in which case catheter ablation is typically performed. […] In patients with asymptomatic pre-excitation who have an accessory pathway demonstrating low risk features on invasive or non-invasive screening, an electrophysiology study and ablation can be considered. […] Symptomatic patients usually undergo catheter ablation as first-line therapy. […] Pharmacological therapy can be considered for patients in whom catheter ablation fails and also for patients who prefer a non-invasive approach. […] Catheter ablation is highly effective with low risk and can be used either as initial therapy or for patients experiencing side effects or arrhythmia recurrences despite medical treatment.

• #2 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  RF ablation is indicated in the following patients: Patients with symptomatic atrioventricular reentrant tachycardia (AVRT); Patients with AF or other atrial tachyarrhythmias that have rapid ventricular response via an AP (preexcited AF); Patients with AVRT or AF with rapid ventricular rates found incidentally during EPS for unrelated dysrhythmia, if the shortest preexcited RR interval during AF is less than 250 ms; Asymptomatic patients with ventricular preexcitation whose livelihood, profession, insurability, or mental well-being may be influenced by unpredictable tachyarrhythmias or in whom such tachyarrhythmias would endanger the public safety; Patients with WPW and a family history of SCD. […] Symptomatic individuals with orthodromic tachycardia should undergo risk assessment and should be offered therapy according to their symptoms. RF ablation can be curative and carried out with a high degree of success, a low complication rate, and a low recurrence rate.

• #2 Wolff-Parkinson-White (WPW) syndrome | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/wolff-parkinson-white-wpw-syndrome?content_id=CON-20206635

  Cardioversion. Paddles or patches on the chest are used to electrically shock the heart and help reset the heart rhythm. Cardioversion is typically used when vagal maneuvers and medicines don’t work. It’s also possible to do cardioversion with medicines. […] Catheter ablation. In this procedure, a doctor inserts one or more thin, flexible tubes called catheters into an artery, usually in the groin. The doctor guides them to the heart. Sensors on the tip of the catheters use heat or cold energy to create tiny scars in the heart. The scars block irregular electrical signals and restore the heart’s rhythm. Catheter ablation may be done at the same time as other heart surgeries.

• #2 Wolff-Parkinson-White syndrome | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/wolff-parkinson-white-syndrome/

  For people with symptoms that are affecting their day to day life, or who have significant episodes, medication can be offered. These may be a beta blocker or other medications to help stabilise the pathway and reduce its ability to cause the fast heart rates. […] The most effective treatment for Wolff-Parkinson- White syndrome is cardiac ablation during an electrophysiology (EP) study. The doctor will use either heating therapy (radio frequency ablation) or freezing therapy (cryoablation) on the affected area, which should stop the abnormal signals. […] Ablation works by using a targeted beam of energy to destroy the tissues causing the abnormal signals. Radio frequency (RF) ablation is effective in around 90 per cent of cases. An alternative method, cryoablation, is used where RF ablation is not suitable. Cryoablation is effective in about 80 per cent of cases, but is safer to use in certain areas of your heart. This procedure is carried out at low risk and as a day case or with an overnight stay.

• #2 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics

  A wire (electrode catheter) is advanced into the heart from large blood vessels and positioned within the chambers of the heart using fluoroscopy (low energy x-rays). After the accessory pathway is localized, radiofrequency energy (high frequency electricity) is delivered to the area to destroy or „ablate” the accessory pathway, preventing it from conducting impulses. […] When performed by experienced specialists, ablation cures the WPW syndrome over 95 percent of the time. Some people have multiple accessory pathways that need to be ablated. Occasionally, the accessory pathway can recover from the ablation, and the ablation procedure needs to be repeated. […] The risk of a major complication is low, approximately 3 percent, with the primary risks being damage to the blood vessels or nerves in the thigh, bleeding, infection, perforation of the heart, and heart block requiring a pacemaker. The risk of specific complications depends in part on the location of the accessory pathway and which critical structures are nearby.

• #2 Wolff–Parkinson–White syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Wolff%E2%80%93Parkinson%E2%80%93White_syndrome

  WPW syndrome may be monitored or treated with either medications or an ablation (destroying the tissues) such as with radiofrequency catheter ablation. […] According to the ACLS protocol, people with WPW who are experiencing rapid abnormal heart rhythms (tachydysrhythmias) may require synchronized electrical cardioversion if they are demonstrating severe signs or symptoms (for example, low blood pressure or lethargy with altered mental status). If they are relatively stable, medication may be used. […] WPW pattern with hemodynamically stability and orthodromic AVRT leading to a regular narrow complex tachycardia may be managed similarly to other regular narrow complex supraventricular tachycardias: first with vagal maneuvers followed by a trial of adenosine (first-line therapy). […] The definitive treatment of WPW is the destruction of the abnormal electrical pathway by catheter ablation. Two main types of catheter ablation include radiofrequency ablation with heat or cryoablation with cold energy.

• #2 Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/wolff-parkinson-white-syndrome-wpw-syndrome

  When a patient with WPW syndrome presents with a rapid, regular, narrow QRS complex tachycardia, the mechanism of the tachycardia is almost always orthodromic atrioventricular reentrant tachycardia and may be treated as any other regular, narrow QRS complex tachycardia. Vagal maneuvers are attempted first. […] If the patient is hemodynamically unstable or unresponsive to other medical therapies, synchronized DC cardioversion is used. For hemodynamically stable patients, IV adenosine is preferred. If unresponsive to IV adenosine, United States guidelines recommend a class IIb such as an IV beta blocker, IV diltiazem, or IV verapamil. […] Long-term therapy of patients who have had a documented WPW syndrome-related tachyarrhythmia (or symptoms highly suggestive thereof) is with catheter ablation of the accessory AV connection(s). A meta-analysis of ablation in WPW syndrome reports a success rate of 94%, a recurrence rate of 6% (usually treated by re-ablation), and a procedure-related complication rate of 1%.

• #2 Wolf–Parkinson–White Syndrome: Diagnosis, Risk Assessment, and Therapy—An Update

  https://www.mdpi.com/2075-4418/14/3/296

  RFA has completely revolutionized the approach to the management of WPW syndrome, becoming the method of choice potentially available to all WPW patients. […] Long-term results from registry studies demonstrated that there is a striking difference in outcomes between ablated and nonablated patients. […] A recent meta-analysis showed that an RF catheter ablation of WPW has a >94% success rate, a recurrence rate of 6.2%, with a complication rate of 1%. […] In the long term, successful WPW ablation is associated with reduced mortality (due to SCD prevention, as well as reduced risk of heart failure). […] Radiofrequency ablation has drastically changed the management of pre-excitation syndromes. Taking into account the high success rate and low incidence of complications, mostly with low impact on quality of life, this curative procedure should be considered, even in asymptomatic patients.

• #2 Wolff-Parkinson-White Syndrome

  https://my.clevelandclinic.org/health/diseases/17643-wolff-parkinson-white-syndrome-wpw

  While radiofrequency ablation is a safe and effective procedure, people who have catheter ablation can get: […] Complications from cardioversion are rare, too. Some people can get blood clots, injury to their skin from the procedure or a worsening arrhythmia. […] Your provider can tell you when symptoms should improve after ablation or surgery for WPW. They can also tell you what to expect during recovery and when you can return to daily activities. […] People who receive treatment for Wolff-Parkinson-White syndrome have a typical life expectancy. Radiofrequency ablation or surgery can cure WPW in many people.

• #2 Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/wolff-parkinson-white-syndrome-wpw-syndrome

  If ablation cannot be performed or if the patient declines ablation, medical therapy may be accomplished with almost any oral antiarrhythmic medication other than digoxin. Class IIa recommendations are given for oral flecainide or oral propafenone in the absence of a structural heart disorder. Class IIb recommendations are given for oral dofetilide, oral sotalol, and oral amiodarone. […] Although a class IIb recommendation is given for oral beta blockers (especially useful if symptoms occur with exercise), oral diltiazem, or oral verapamil, there is a small possibility that these mediations could be harmful should atrial fibrillation ever occur.

• #2 Wolff-Parkinson-White (WPW) Syndrome | Doctor

  https://patient.info/doctor/wolff-parkinson-white-syndrome-pro

  Patients who present with tachyarrhythmic symptoms may require drug therapy to prevent further episodes and while awaiting definitive treatment – this may also be a long-term option for those in whom ablation or surgery are contraindicated, or not wanted. […] Digoxin is contra-indicated in patients with WPW syndrome. Most deaths from WPW syndrome have been associated with digoxin use. […] RF ablation is increasingly being used both in common types of arrhythmia and selected asymptomatic patients, with a 95% success rate. […] This is now first-line management, ahead of open-heart surgical disconnection and cardiac pacing. […] Indications for RF ablation include: Patients with symptomatic AV re-entrant tachycardia. […] Surgical ablation may still be indicated for patients in whom RF ablation has failed, those who need heart surgery for other reasons and for those patients with multifocal abnormalities requiring surgical ablation (rare).

• #2 Wolff Parkinson White Syndrome – The Cardiology Advisor

  https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/cardiology/wolff-parkinson-white-syndrome-diagnosis-and-treatment/

  In the case of long-term oral medication, it is recommended to use drugs that impede conduction through accessory pathways (e.g. class IA, IC or III agents). Sodium channel blockers (class IA and IC antiarrhythmics) and certain class III antiarrhythmic medications are particularly effective in slowing down conduction as well as prolonging the refractory period of accessory pathways and atrioventricular node; thus, they are considered optimal for this particular condition. […] Digitalis, beta blockers, and calcium channel blockers are effective in inhibiting conduction through the AV node; however, they do not impede conduction over most accessory pathways. On the contrary, these drugs may actually reduce the refractory period of an accessory pathway which could lead to a faster ventricular rate (and a risk of hemodynamic collapse) if administered to individuals suffering from WPW syndrome who experience atrial flutter.

• #2 Wolff Parkinson White Syndrome – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/wolff-parkinson-white-syndrome/

  In the case of long-term oral medication, it is recommended to use drugs that impede conduction through accessory pathways (e.g. class IA, IC or III agents). Sodium channel blockers (class IA and IC antiarrhythmics) and certain class III antiarrhythmic medications are particularly effective in slowing down conduction as well as prolonging the refractory period of accessory pathways and atrioventricular node; thus, they are considered optimal for this particular condition. […] Digitalis, beta blockers, and calcium channel blockers are effective in inhibiting conduction through the AV node; however, they do not impede conduction over most accessory pathways. On the contrary, these drugs may actually reduce the refractory period of an accessory pathway which could lead to a faster ventricular rate (and a risk of hemodynamic collapse) if administered to individuals suffering from WPW syndrome who experience atrial flutter.

• #2 Wolff-Parkinson-White syndrome (WPW): MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000151.htm

  Medicines, particularly antiarrhythmic drugs such as procainamide or amiodarone, may be used to control or prevent a rapid heartbeat. […] If the heart rate does not return to normal with medical treatment, health care providers may use a type of therapy called electrical cardioversion (shock). […] The long-term treatment for WPW syndrome is very often catheter ablation. This procedure involves inserting a tube (catheter) into a vein through a small cut near the groin up to the heart area. When the tip reaches the heart, the small area that is causing the fast heart rate is destroyed using a special type of energy called radiofrequency or by freezing it (cryoablation). This is done as part of an electrophysiologic study (EPS). […] Open heart surgery to burn or freeze the extra pathway may also provide a permanent cure for WPW syndrome. In most cases, this procedure is done only if you need heart surgery for other reasons. […] Catheter ablation cures this disorder in most people. The success rate for the procedure ranges between 85% to 95%. Success rates will vary depending on the location and number of extra pathways.

• #2 Surgical treatment of Wolff-Parkinson-White syndrome: Resuscitation of a forgotten technique

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10267807/

  This article describes, in detail, the techniques of surgical ablation for Wolff-Parkinson-White syndrome. Surgery is now rarely performed for this indication but may be necessary in refractory cases. […] In most patients, catheter ablation will provide a cure for WPW; however, in select, refractory cases there is still a role for surgical intervention. […] The procedure was performed through a median sternotomy under cardiopulmonary bypass but without cardioplegic arrest. […] This surgical technique report is presented to demonstrate the need for knowledge of surgical technique to appropriately care for rare patients who require surgical ablation for WPW.

• #2 Surgical treatment of Wolff-Parkinson-White syndrome: Resuscitation of a forgotten technique – JTCVS Techniques

  https://www.jtcvstechniques.org/article/S2666-2507(23)00063-9/fulltext

  Surgery is now rarely performed for this indication but may be necessary in refractory cases. […] However, in select, refractory cases there is still a role for surgical intervention. […] The procedure was performed through a median sternotomy under cardiopulmonary bypass but without cardioplegic arrest. […] This surgical technique report is presented to demonstrate the need for knowledge of surgical technique to appropriately care for rare patients who require surgical ablation for WPW.

• #2 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics

  Surgery — Surgery is another method to disconnect the WPW pathway. The success rate for surgical ablation is close to 100 percent and the complication rate is low. However, radiofrequency ablation is a less invasive option; as a result, surgery is now rarely performed. Surgical ablation may be preferred if the person is undergoing cardiac surgery for other reasons (such as coronary artery bypass surgery or valve surgery) and is recommended when radiofrequency ablation and medications are not effective. […] Medications — Medications can prevent recurrences of tachycardia in some people with WPW, but they are usually used only in people who are not candidates for ablation or surgery. These people may be given medications to use during an episode or to take daily to prevent the arrhythmia. They may also be taught to perform maneuvers (eg, Valsalva) that can stop the tachycardia.

• #2 Wolff-Parkinson-White Syndrome: What Treatment?

  https://www.patientcareonline.com/view/wolff-parkinson-white-syndrome-what-treatment

  WPW syndrome is the most common type of ventricular preexcitation syndrome. […] Treatment is not necessary for patients with asymptomatic preexcitation or infrequent, asymptomatic tachycardias. Acute management of symptomatic or persistent tachycardias depends on the underlying mechanism. […] Patients with WPW syndrome associated with atrial fibrillation or flutter should be treated only with procainamide or cardioversion. Ibutilide, a newer agent, has also shown promise in these patients. […] Drugs, surgery, and radiofrequency ablation have been used to prevent the recurrence of tachycardia in patients with WPW syndrome. Medical therapy (with the same agents used for acute management) may be appropriate for patients who have infrequent symptoms. However, because the long-term efficacy and side effects of these medications in patients with WPW syndrome are unknown, ablation has become more widely used. Surgical ablation offers an almost 100% cure rate. However, radiofrequency ablation is less invasive, more cost-effective, and almost as successful, with cure rates ranging from 90% to 95%. The complication rate of radiofrequency ablation is 2.1% and the mortality rate is 0.1% to 0.3%.

• #2 Wolff-Parkinson-White Syndrome – Seattle Children’s

  https://www.seattlechildrens.org/conditions/wolff-parkinson-white-syndrome/

  Children with WPW do not always need treatment. Often, an irregular heartbeat does not cause any problems. But sometimes it keeps the heart from pumping the right amount of blood to the brain or other organs. This can be dangerous. So, it is important to have your childs heart checked by a doctor who can offer treatment if your child needs it. […] Your child may need treatment if they have symptoms or they have a fast heartbeat that happens often or lasts for a while. Doctors treat WPW first with medicines that control the heart rate. […] If medicine does not work well enough, doctors may use ablation. They may also use ablation to get rid of an abnormal electrical pathway if it poses a dangerous risk to your child. […] Ablation is a procedure that uses a thin plastic tube (catheter) to destroy the tissue that causes the rapid heartbeat. Traditionally, doctors did this with a catheter that used radiofrequency energy to burn (cauterize) the abnormal tissue.

• #2 Wolff-Parkinson-White Syndrome (WPW) | UpBeat.org – powered by the Heart Rhythm Society

  https://upbeat.org/pediatrics/wolff-parkinson-white-syndrome-wpw

  Treatment may include medication to prevent SVT. In babies, medication is given to prevent SVT for the first year. Up to 2/3 of babies will „outgrow” WPW when diagnosed at an early age (in the first year of life) and will not require further treatment. […] Cardiac (heart) ablation has become the first line of treatment in older patients, especially in older children or adults.

• #2 Wolff-Parkinson-White (WPW) Syndrome – Heart and Blood Vessel Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/heart-and-blood-vessel-disorders/abnormal-heart-rhythms/wolff-parkinson-white-wpw-syndrome

  Episodes of paroxysmal supraventricular tachycardia due to Wolff-Parkinson-White syndrome can often be stopped by one of several maneuvers that stimulate the vagus nerve and thus slow the heart rate. Maneuvers include […] When these maneuvers are ineffective, medications such as verapamil, diltiazem, or adenosine are usually given intravenously to stop the arrhythmia. Antiarrhythmic medications may then be continued indefinitely to prevent episodes of a fast heart rate […] In infants and children younger than 10 years, digoxin may be given to suppress episodes of paroxysmal supraventricular tachycardia due to Wolff-Parkinson-White syndrome. However, adults with the syndrome should not take digoxin because it can facilitate conduction by the extra pathway and increase the risk that atrial fibrillation will degenerate into ventricular fibrillation.

• #2 Get Wolff-Parkinson-White Syndrome Treatment | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/wolff-parkinson-white-syndrome-treatment

  Treatment like radiofrequency ablation often solves the problem. If not, your child’s provider may recommend managing symptoms with vagal maneuvers, and/or medications. If your child doesn’t have symptoms, we may recommend watchful management, where we keep a close eye on your child with regular appointments. If new symptoms come up or existing ones get worse, we can treat them quickly. […] Arrhythmias caused by Wolff-Parkinson-White syndrome are treatable. And the pediatric cardiology providers at Cleveland Clinic Childrens are here to help. We’ll work with you and your child to pinpoint what’s causing their too-fast heart rate. And we’ll build the best treatment plan for their needs.

• #2 Wolff-Parkinson-White Syndrome – Seattle Children’s

  https://www.seattlechildrens.org/conditions/wolff-parkinson-white-syndrome/

  Now, doctors sometimes use cryoablation. This method destroys the tissue by freezing it. This newer technique may be safer. It also seems that the heart tissue is able to recover better after cryoablation. Talk with your heart doctor about which method is best for your child. […] We offer a full range of diagnostic procedures and treatments. Along with using heart medicines, we have deep experience with radiofrequency ablation and cryoablation procedures in children who need them to correct an abnormal heart rhythm. […] Doctors at Seattle Childrens are working to advance treatment for WPW and enhance the quality of life for children with this condition. […] We were the first institution in the region to routinely offer cryoablation for children, greatly increasing the safety of ablation for arrhythmia. […] Seattle Childrens is one of the few institutions in the region to offer zero fluoro or minimal fluoro ablation. This means we use techniques many that we developed to expose your child to little or no X-ray radiation. Most places use fluoroscopy during ablation.

• #2 Get Wolff-Parkinson-White Syndrome Treatment | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/wolff-parkinson-white-syndrome-treatment

  Your child may not need treatment, especially if they don’t have ongoing symptoms. But if they have a constantly rapid heart rate and dizziness, fainting and shortness of breath their provider may recommend one or a combination of treatments, like: […] If your child is old enough (and their providers feel this treatment is right for them), we’ll teach them to use vagal maneuvers. These can activate the vagus nerve to help slow their heart rate: […] Your child’s care team may recommend cardioversion to get their heart back to beating at a normal rhythm. Chemical cardioversion uses medications given as a pill or through an IV (in a vein in their arm) to slow their heart rate. Electrical cardioversion uses a device to send a shock to their heart when they need it. […] Our pediatric cardiology experts use catheter ablation, a type of ablation therapy, to „destroy” the abnormal pathway. Either heat (radiofrequency ablation) or cold (cryoablation) can help disrupt the electrical signals causing irregular heartbeats.

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abo7611

  Your doctor may prescribe medicines to help slow down your heartbeat. […] Your doctor may also suggest you try vagal manoeuvres when having an episode of WPW. […] In some cases, a procedure called catheter ablation is done. […] Be safe with medicines. Take your medicines exactly as prescribed. […] If your doctor showed you how to do vagal manoeuvres, try them when you have an episode. […] Do not use over-the-counter decongestants, diet pills, or „pep” pills. […] If you need help quitting, talk to your doctor about stop-smoking programs and medicines.

• #2 Wolff-Parkinson-White Syndrome (WPW) – Symptoms, Tests & Treatments – BHF

  https://www.bhf.org.uk/informationsupport/conditions/wolff-parkinson-white-syndrome

  Techniques and treatments that can help prevent episodes include: Medication to control the speed of the electrical messages being sent to your heart or to take during an episode. […] Lifestyle choices you may be told to avoid things that could trigger an episode. This can include having less alcohol and caffeine and avoiding intense exercise, like running or competitive sports. Your doctor can answer any questions you might have. […] Catheter ablation this procedure is commonly used to destroy the extra part of the heart causing the problems in the heart’s electrical system. It works with most people and is very effective. […] Even if you dont need treatment, its important to go to all your appointments with your doctor or specialist. They will regularly check how your heart is working to keep you healthy. If your specialist thinks you need treatment, theyll discuss the options with you.

• #2 WOLFF-PARKINSON-WHITE DISORDER | Sports Medicine Today

  https://www.sportsmedtoday.com/wolffparkinsonwhite-disorder-va-266.htm

  WPW is diagnosed by looking at the hearts electrical activity with an electrocardiogram (ECG or EKG). […] If WPW is diagnosed, the patient will need to see a cardiologist to identify the type and speed of the abnormal electrical pathway. If treatment is needed, the cardiologist will consider a procedure called a catheter ablation. This gets rid of the extra electrical pathway, which can cure the disorder. […] If the athlete has symptoms, has a high-risk pathway, or participates in high-risk sports, then the athlete needs to see a cardiologist to consider an ablation. After the procedure, if there are no symptoms and there is a normal ECG, an athlete can consider returning to play.

• #3 Treatment of arrhythmias associated with the Wolff-Parkinson-White syndrome – UpToDate

  https://www.uptodate.com/contents/treatment-of-arrhythmias-associated-with-the-wolff-parkinson-white-syndrome

  Treatment of arrhythmias associated with the Wolff-Parkinson-White syndrome […] This topic will review the available therapeutic options for the treatment and prevention of arrhythmias in WPW syndrome. […] Patients who present with an acute arrhythmia require pharmacologic therapy for restoration of sinus rhythm. […] Unstable patients should undergo urgent electrical cardioversion. […] Stable patients should be evaluated to determine the type of arrhythmia present. […] Catheter ablation as initial therapy is recommended for the prevention of recurrent arrhythmias. […] Alternative therapy includes antiarrhythmic drugs. […] Therapy for recurrence may involve repeat catheter ablation and surgical ablation.

• #3 Patient education: Wolff-Parkinson-White syndrome (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/wolff-parkinson-white-syndrome-beyond-the-basics

  WOLFF-PARKINSON-WHITE TREATMENT […] Most people with the WPW pattern on ECG who do not experience tachycardia do not need treatment. These people may never develop symptoms, and in some young people, conduction via the accessory pathway spontaneously disappears as the person grows older. […] […] However, some people who are asymptomatic but have a WPW ECG pattern (such as people with a high-risk occupation or professional athletes) are advised to undergo additional testing, including electrophysiologic testing, to determine if the accessory pathway is associated with a high risk of sudden cardiac arrest. […] People with WPW syndrome require treatment when or if they have an episode of tachycardia due to the serious potential risks of the tachycardia. Treatment focuses on stopping the tachycardia and preventing it from recurring.

• #3 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  The two main treatment approaches to WPW syndrome are (1) pharmacotherapy and (2) EPS with RF catheter ablation. EPS with ablation is the first-line treatment for symptomatic WPW syndrome and for patients with high-risk occupations. It has replaced surgical treatment and most drug treatments. RF ablation used in conjunction with cryoablation for septal APs and APs near small coronary arteries has had high success rates with low risk. […] Drug therapy can be useful in some instances, such as in patients who refuse RF ablation and in temporizing patients with a higher risk of ablation-related complications (eg, AV block with pacing requirement for anteroseptal or midseptal pathways). Medical therapy may also be appropriate in pregnant women until radiation exposure is safe. […] In choosing drug therapy, keep in mind that class Ic and class III antiarrhythmic medications will slow AP conduction, facilitating blockage of SVT. If the patient has a history of AF or atrial flutter, an AV nodal blocking medication should also be used.

• #3 Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/wolff-parkinson-white-syndrome-wpw-syndrome

  When a patient with WPW syndrome presents with a rapid, regular, narrow QRS complex tachycardia, the mechanism of the tachycardia is almost always orthodromic atrioventricular reentrant tachycardia and may be treated as any other regular, narrow QRS complex tachycardia. Vagal maneuvers are attempted first. […] If the patient is hemodynamically unstable or unresponsive to other medical therapies, synchronized DC cardioversion is used. For hemodynamically stable patients, IV adenosine is preferred. If unresponsive to IV adenosine, United States guidelines recommend a class IIb such as an IV beta blocker, IV diltiazem, or IV verapamil. […] Long-term therapy of patients who have had a documented WPW syndrome-related tachyarrhythmia (or symptoms highly suggestive thereof) is with catheter ablation of the accessory AV connection(s). A meta-analysis of ablation in WPW syndrome reports a success rate of 94%, a recurrence rate of 6% (usually treated by re-ablation), and a procedure-related complication rate of 1%.

• #3 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554437/

  The pharmacologic treatment of choice for antidromic AVRT is procainamide. In the setting of preexcitation and atrial fibrillation, AV nodal blockade is contraindicated. Procainamide and ibutilide are agents of choice in atrial fibrillation with preexcitation on ECG. Amiodarone has been used in WPW pattern with atrial fibrillation, but some evidence suggests that it is less effective and has a higher risk of precipitating ventricular fibrillation. […] Patients with WPW pattern on ECG who present with hemodynamically stability, orthodromic AVRT will demonstrate a regular narrow complex tachycardia. They can be managed similarly to other regular narrow complex supraventricular tachycardias. Vagal maneuvers followed by a trial of adenosine are the first-line therapy. The 2015 ACC/AHA/HRS guidelines recommend beta-blockers or calcium channel blockers as the second-line agents with electric cardioversion being reserved for refractory arrhythmias.

• #3 Atrial Fibrillation and Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/atrial-fibrillation-and-wolff-parkinson-white-syndrome-wpw-syndrome

  The treatment of choice for Wolff-Parkinson-White syndrome with atrial fibrillation is direct current cardioversion (1). The usual rate-slowing medications used in atrial fibrillation are not effective, and digoxin, adenosine, and the nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) that may be used in many other forms of supraventricular tachycardia are contraindicated because they may increase the ventricular rate and cause ventricular fibrillation. […] If cardioversion is impossible, medications that prolong the refractory period of the accessory connection should be used. IV procainamide or ibutilide is preferred (1), but any class Ia, class Ic, or class III antiarrhythmic medication can be used. […] Do not give digoxin, adenosine, or nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) to patients with atrial fibrillation and Wolff-Parkinson-White syndrome because these medications may trigger ventricular fibrillation.

• #3 A Case of Supraventricular Tachycardia Associated With Wolff-Parkinson-White Syndrome | Chee | Journal of Medical Cases

  https://www.journalmc.org/index.php/JMC/article/view/2693/2318

  Unstable patient with WPW syndrome related atrial fibrillation is best managed with synchronized cardioversion. […] Medications with significant AV nodal blocking effects should be avoided in all instances. […] Adenosine is widely used in an acute care setting and is generally considered to be safe and effective diagnostic and therapeutic agent. […] This case also highlights the importance of following up patients following successful management of arrhythmia/SVT.

• #3 Wolff–Parkinson–White syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Wolff%E2%80%93Parkinson%E2%80%93White_syndrome

  WPW syndrome may be monitored or treated with either medications or an ablation (destroying the tissues) such as with radiofrequency catheter ablation. […] According to the ACLS protocol, people with WPW who are experiencing rapid abnormal heart rhythms (tachydysrhythmias) may require synchronized electrical cardioversion if they are demonstrating severe signs or symptoms (for example, low blood pressure or lethargy with altered mental status). If they are relatively stable, medication may be used. […] WPW pattern with hemodynamically stability and orthodromic AVRT leading to a regular narrow complex tachycardia may be managed similarly to other regular narrow complex supraventricular tachycardias: first with vagal maneuvers followed by a trial of adenosine (first-line therapy). […] The definitive treatment of WPW is the destruction of the abnormal electrical pathway by catheter ablation. Two main types of catheter ablation include radiofrequency ablation with heat or cryoablation with cold energy.

• #3 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  RF ablation is indicated in the following patients: Patients with symptomatic atrioventricular reentrant tachycardia (AVRT); Patients with AF or other atrial tachyarrhythmias that have rapid ventricular response via an AP (preexcited AF); Patients with AVRT or AF with rapid ventricular rates found incidentally during EPS for unrelated dysrhythmia, if the shortest preexcited RR interval during AF is less than 250 ms; Asymptomatic patients with ventricular preexcitation whose livelihood, profession, insurability, or mental well-being may be influenced by unpredictable tachyarrhythmias or in whom such tachyarrhythmias would endanger the public safety; Patients with WPW and a family history of SCD. […] Symptomatic individuals with orthodromic tachycardia should undergo risk assessment and should be offered therapy according to their symptoms. RF ablation can be curative and carried out with a high degree of success, a low complication rate, and a low recurrence rate.

• #3 Wolf–Parkinson–White Syndrome: Diagnosis, Risk Assessment, and Therapy—An Update

  https://www.mdpi.com/2075-4418/14/3/296

  RFA has completely revolutionized the approach to the management of WPW syndrome, becoming the method of choice potentially available to all WPW patients. […] Long-term results from registry studies demonstrated that there is a striking difference in outcomes between ablated and nonablated patients. […] A recent meta-analysis showed that an RF catheter ablation of WPW has a >94% success rate, a recurrence rate of 6.2%, with a complication rate of 1%. […] In the long term, successful WPW ablation is associated with reduced mortality (due to SCD prevention, as well as reduced risk of heart failure). […] Radiofrequency ablation has drastically changed the management of pre-excitation syndromes. Taking into account the high success rate and low incidence of complications, mostly with low impact on quality of life, this curative procedure should be considered, even in asymptomatic patients.

• #3 Wolff-Parkinson-White syndrome: Diagnostic and management strategies | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/92/2/119

  Catheter ablation has a class I (strong) recommendation in patients who have symptoms and the WPW pattern (WPW syndrome). Catheter ablation has a high success rate (94%) and low complication rate (1%). […] The management challenge lies in those with WPW pattern but no symptoms. The goals are to alleviate symptoms related to tachyarrhythmias and to prevent the most feared complication, sudden cardiac death. […] Noninvasive risk stratification can help guide the decision for catheter ablation. […] Electrophysiologic studies are invasive, involving intracardiac electrodes and catheters to look for and evaluate the characteristics of accessory pathways. […] More electrophysiologists now than in the past may be performing electrophysiologic studies in patients with an asymptomatic WPW pattern regardless of noninvasive findings. […] Given the low risk and potential for a permanent cure via catheter ablation, there is an incentive to identify and manage WPW syndrome proactively. […] In patients who remain asymptomatic and do not require ablation, observation with conservative management is an acceptable approach.

• #3 Wolff-Parkinson-White Syndrome: What Treatment?

  https://www.patientcareonline.com/view/wolff-parkinson-white-syndrome-what-treatment

  WPW syndrome is the most common type of ventricular preexcitation syndrome. […] Treatment is not necessary for patients with asymptomatic preexcitation or infrequent, asymptomatic tachycardias. Acute management of symptomatic or persistent tachycardias depends on the underlying mechanism. […] Patients with WPW syndrome associated with atrial fibrillation or flutter should be treated only with procainamide or cardioversion. Ibutilide, a newer agent, has also shown promise in these patients. […] Drugs, surgery, and radiofrequency ablation have been used to prevent the recurrence of tachycardia in patients with WPW syndrome. Medical therapy (with the same agents used for acute management) may be appropriate for patients who have infrequent symptoms. However, because the long-term efficacy and side effects of these medications in patients with WPW syndrome are unknown, ablation has become more widely used. Surgical ablation offers an almost 100% cure rate. However, radiofrequency ablation is less invasive, more cost-effective, and almost as successful, with cure rates ranging from 90% to 95%. The complication rate of radiofrequency ablation is 2.1% and the mortality rate is 0.1% to 0.3%.

• #3 Wolff-Parkinson-White Syndrome: Symptoms, Treatment, More

  https://www.healthline.com/health/arrhythmia/wolff-parkinson-white-syndrome

  WPW syndrome is a common cause of a type of heart arrhythmia called paroxysmal supraventricular tachycardia. Its a type of fast heart rhythm that comes and goes. […] Asymptomatic WPW syndrome doesnt necessarily require treatment, but you will need to visit a doctor for regular checkups. […] However, if you do have symptoms, a doctor may recommend certain treatments based on the severity and frequency of your symptoms. […] Some treatments and lifestyle changes may help prevent future WPW syndrome episodes. These include: undergoing catheter ablation, a potentially curative procedure and the most common treatment for WPW syndrome, works to destroy the extra heart muscle fiber; taking antiarrhythmic drugs, such as amiodarone (Pacerone, Nexterone), procainamide (Pronestyl), sotalol (Betapace, Sorine), dofetilide (Tikosyn); avoiding high amounts of caffeine or alcohol; making exercise modifications, as more strenuous workouts can contribute to WPW syndrome symptoms; managing stress.

• #3 Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/wolff-parkinson-white-syndrome-wpw-syndrome

  If ablation cannot be performed or if the patient declines ablation, medical therapy may be accomplished with almost any oral antiarrhythmic medication other than digoxin. Class IIa recommendations are given for oral flecainide or oral propafenone in the absence of a structural heart disorder. Class IIb recommendations are given for oral dofetilide, oral sotalol, and oral amiodarone. […] Although a class IIb recommendation is given for oral beta blockers (especially useful if symptoms occur with exercise), oral diltiazem, or oral verapamil, there is a small possibility that these mediations could be harmful should atrial fibrillation ever occur.

• #3 Wolff Parkinson White Syndrome – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/wolff-parkinson-white-syndrome/

  In the case of long-term oral medication, it is recommended to use drugs that impede conduction through accessory pathways (e.g. class IA, IC or III agents). Sodium channel blockers (class IA and IC antiarrhythmics) and certain class III antiarrhythmic medications are particularly effective in slowing down conduction as well as prolonging the refractory period of accessory pathways and atrioventricular node; thus, they are considered optimal for this particular condition. […] Digitalis, beta blockers, and calcium channel blockers are effective in inhibiting conduction through the AV node; however, they do not impede conduction over most accessory pathways. On the contrary, these drugs may actually reduce the refractory period of an accessory pathway which could lead to a faster ventricular rate (and a risk of hemodynamic collapse) if administered to individuals suffering from WPW syndrome who experience atrial flutter.

• #3 Wolff-Parkinson-White (WPW) Syndrome | Doctor

  https://patient.info/doctor/wolff-parkinson-white-syndrome-pro

  Patients who present with tachyarrhythmic symptoms may require drug therapy to prevent further episodes and while awaiting definitive treatment – this may also be a long-term option for those in whom ablation or surgery are contraindicated, or not wanted. […] Digoxin is contra-indicated in patients with WPW syndrome. Most deaths from WPW syndrome have been associated with digoxin use. […] RF ablation is increasingly being used both in common types of arrhythmia and selected asymptomatic patients, with a 95% success rate. […] This is now first-line management, ahead of open-heart surgical disconnection and cardiac pacing. […] Indications for RF ablation include: Patients with symptomatic AV re-entrant tachycardia. […] Surgical ablation may still be indicated for patients in whom RF ablation has failed, those who need heart surgery for other reasons and for those patients with multifocal abnormalities requiring surgical ablation (rare).

• #3 Surgical treatment of Wolff-Parkinson-White syndrome: Resuscitation of a forgotten technique

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10267807/

  This article describes, in detail, the techniques of surgical ablation for Wolff-Parkinson-White syndrome. Surgery is now rarely performed for this indication but may be necessary in refractory cases. […] In most patients, catheter ablation will provide a cure for WPW; however, in select, refractory cases there is still a role for surgical intervention. […] The procedure was performed through a median sternotomy under cardiopulmonary bypass but without cardioplegic arrest. […] This surgical technique report is presented to demonstrate the need for knowledge of surgical technique to appropriately care for rare patients who require surgical ablation for WPW.

• #3 Surgical treatment of Wolff-Parkinson-White syndrome: Resuscitation of a forgotten technique – JTCVS Techniques

  https://www.jtcvstechniques.org/article/S2666-2507(23)00063-9/fulltext

  Surgery is now rarely performed for this indication but may be necessary in refractory cases. […] However, in select, refractory cases there is still a role for surgical intervention. […] The procedure was performed through a median sternotomy under cardiopulmonary bypass but without cardioplegic arrest. […] This surgical technique report is presented to demonstrate the need for knowledge of surgical technique to appropriately care for rare patients who require surgical ablation for WPW.

• #3 Wolff-Parkinson-White Syndrome (WPW) | UpBeat.org – powered by the Heart Rhythm Society

  https://upbeat.org/pediatrics/wolff-parkinson-white-syndrome-wpw

  Treatment may include medication to prevent SVT. In babies, medication is given to prevent SVT for the first year. Up to 2/3 of babies will „outgrow” WPW when diagnosed at an early age (in the first year of life) and will not require further treatment. […] Cardiac (heart) ablation has become the first line of treatment in older patients, especially in older children or adults.

• #3 Get Wolff-Parkinson-White Syndrome Treatment | Cleveland Clinic Children’s

  https://my.clevelandclinic.org/pediatrics/services/wolff-parkinson-white-syndrome-treatment

  Your child may not need treatment, especially if they don’t have ongoing symptoms. But if they have a constantly rapid heart rate and dizziness, fainting and shortness of breath their provider may recommend one or a combination of treatments, like: […] If your child is old enough (and their providers feel this treatment is right for them), we’ll teach them to use vagal maneuvers. These can activate the vagus nerve to help slow their heart rate: […] Your child’s care team may recommend cardioversion to get their heart back to beating at a normal rhythm. Chemical cardioversion uses medications given as a pill or through an IV (in a vein in their arm) to slow their heart rate. Electrical cardioversion uses a device to send a shock to their heart when they need it. […] Our pediatric cardiology experts use catheter ablation, a type of ablation therapy, to „destroy” the abnormal pathway. Either heat (radiofrequency ablation) or cold (cryoablation) can help disrupt the electrical signals causing irregular heartbeats.

• #3 Wolff-Parkinson-White Syndrome – Seattle Children’s

  https://www.seattlechildrens.org/conditions/wolff-parkinson-white-syndrome/

  Children with WPW do not always need treatment. Often, an irregular heartbeat does not cause any problems. But sometimes it keeps the heart from pumping the right amount of blood to the brain or other organs. This can be dangerous. So, it is important to have your childs heart checked by a doctor who can offer treatment if your child needs it. […] Your child may need treatment if they have symptoms or they have a fast heartbeat that happens often or lasts for a while. Doctors treat WPW first with medicines that control the heart rate. […] If medicine does not work well enough, doctors may use ablation. They may also use ablation to get rid of an abnormal electrical pathway if it poses a dangerous risk to your child. […] Ablation is a procedure that uses a thin plastic tube (catheter) to destroy the tissue that causes the rapid heartbeat. Traditionally, doctors did this with a catheter that used radiofrequency energy to burn (cauterize) the abnormal tissue.

• #3

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abo7611

  Your doctor may prescribe medicines to help slow down your heartbeat. […] Your doctor may also suggest you try vagal manoeuvres when having an episode of WPW. […] In some cases, a procedure called catheter ablation is done. […] Be safe with medicines. Take your medicines exactly as prescribed. […] If your doctor showed you how to do vagal manoeuvres, try them when you have an episode. […] Do not use over-the-counter decongestants, diet pills, or „pep” pills. […] If you need help quitting, talk to your doctor about stop-smoking programs and medicines.

• #3 Wolff-Parkinson-White Syndrome: Symptoms, Treatment, More

  https://www.healthline.com/health/arrhythmia/wolff-parkinson-white-syndrome

  Other treatments, such as cardioversion and injectable adenosine, may help stop severe WPW syndrome episodes as they happen. […] However, if your symptoms are infrequent and usually mild, a doctor may recommend lifestyle changes and regular checkups to help monitor your condition. […] WPW syndrome may be mild enough to not require treatment, but it wont go away without medical treatment. Catheter ablation is the only possible cure for WPW syndrome.

• #3 Wolff-Parkinson-White Syndrome

  https://my.clevelandclinic.org/health/diseases/17643-wolff-parkinson-white-syndrome-wpw

  While radiofrequency ablation is a safe and effective procedure, people who have catheter ablation can get: […] Complications from cardioversion are rare, too. Some people can get blood clots, injury to their skin from the procedure or a worsening arrhythmia. […] Your provider can tell you when symptoms should improve after ablation or surgery for WPW. They can also tell you what to expect during recovery and when you can return to daily activities. […] People who receive treatment for Wolff-Parkinson-White syndrome have a typical life expectancy. Radiofrequency ablation or surgery can cure WPW in many people.

• #4 Asymptomatic Ventricular Preexcitation (Wolff-Parkinson-White Pattern): When to Be Concerned

  https://www.acc.org/Latest-in-Cardiology/Articles/2022/02/17/13/25/Asymptomatic-Ventricular-Preexcitation

  A significant proportion of patients with ventricular preexcitation remain asymptomatic yet at the risk of life-threatening arrhythmias. […] Shared-decision making must be performed before offering catheter ablation. […] The management of these patients remains controversial. […] One meta-analysis estimated the overall lifetime risk of SCD in asymptomatic WPW patients to 3-4%, with most cases between ages 10 and 40 years. […] Accurate identification of high-risk features for SCD can help prevent this dreaded outcome. […] Noninvasive testing is generally considered safe and should be considered in asymptomatic WPW patients. […] Catheter ablation techniques and experience have improved the safety profile of the procedure. Essentially, catheter ablation can potentially cure WPW syndrome, thereby eliminating the risk of SCD associated with VPE. However, debate remains around when and whether ablation should be performed in asymptomatic WPW patients. […] In general, if an AP contributes to a clinical arrhythmia, if any high-risk feature is present, or if there are multiple APs, then catheter ablation is recommended. […] Prophylactic catheter ablation is reasonable for asymptomatic patients with high-risk features.

• #4 Wolff-Parkinson-White Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554437/

  The pharmacologic treatment of choice for antidromic AVRT is procainamide. In the setting of preexcitation and atrial fibrillation, AV nodal blockade is contraindicated. Procainamide and ibutilide are agents of choice in atrial fibrillation with preexcitation on ECG. Amiodarone has been used in WPW pattern with atrial fibrillation, but some evidence suggests that it is less effective and has a higher risk of precipitating ventricular fibrillation. […] Patients with WPW pattern on ECG who present with hemodynamically stability, orthodromic AVRT will demonstrate a regular narrow complex tachycardia. They can be managed similarly to other regular narrow complex supraventricular tachycardias. Vagal maneuvers followed by a trial of adenosine are the first-line therapy. The 2015 ACC/AHA/HRS guidelines recommend beta-blockers or calcium channel blockers as the second-line agents with electric cardioversion being reserved for refractory arrhythmias.

• #4 Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/wolff-parkinson-white-syndrome-wpw-syndrome

  When a patient with WPW syndrome presents with a rapid, regular, narrow QRS complex tachycardia, the mechanism of the tachycardia is almost always orthodromic atrioventricular reentrant tachycardia and may be treated as any other regular, narrow QRS complex tachycardia. Vagal maneuvers are attempted first. […] If the patient is hemodynamically unstable or unresponsive to other medical therapies, synchronized DC cardioversion is used. For hemodynamically stable patients, IV adenosine is preferred. If unresponsive to IV adenosine, United States guidelines recommend a class IIb such as an IV beta blocker, IV diltiazem, or IV verapamil. […] Long-term therapy of patients who have had a documented WPW syndrome-related tachyarrhythmia (or symptoms highly suggestive thereof) is with catheter ablation of the accessory AV connection(s). A meta-analysis of ablation in WPW syndrome reports a success rate of 94%, a recurrence rate of 6% (usually treated by re-ablation), and a procedure-related complication rate of 1%.

• #4 Atrial Fibrillation and Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/atrial-fibrillation-and-wolff-parkinson-white-syndrome-wpw-syndrome

  The treatment of choice for Wolff-Parkinson-White syndrome with atrial fibrillation is direct current cardioversion (1). The usual rate-slowing medications used in atrial fibrillation are not effective, and digoxin, adenosine, and the nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) that may be used in many other forms of supraventricular tachycardia are contraindicated because they may increase the ventricular rate and cause ventricular fibrillation. […] If cardioversion is impossible, medications that prolong the refractory period of the accessory connection should be used. IV procainamide or ibutilide is preferred (1), but any class Ia, class Ic, or class III antiarrhythmic medication can be used. […] Do not give digoxin, adenosine, or nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) to patients with atrial fibrillation and Wolff-Parkinson-White syndrome because these medications may trigger ventricular fibrillation.

• #4 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  RF ablation is indicated in the following patients: Patients with symptomatic atrioventricular reentrant tachycardia (AVRT); Patients with AF or other atrial tachyarrhythmias that have rapid ventricular response via an AP (preexcited AF); Patients with AVRT or AF with rapid ventricular rates found incidentally during EPS for unrelated dysrhythmia, if the shortest preexcited RR interval during AF is less than 250 ms; Asymptomatic patients with ventricular preexcitation whose livelihood, profession, insurability, or mental well-being may be influenced by unpredictable tachyarrhythmias or in whom such tachyarrhythmias would endanger the public safety; Patients with WPW and a family history of SCD. […] Symptomatic individuals with orthodromic tachycardia should undergo risk assessment and should be offered therapy according to their symptoms. RF ablation can be curative and carried out with a high degree of success, a low complication rate, and a low recurrence rate.

• #4 Wolf–Parkinson–White Syndrome: Diagnosis, Risk Assessment, and Therapy—An Update

  https://www.mdpi.com/2075-4418/14/3/296

  RFA has completely revolutionized the approach to the management of WPW syndrome, becoming the method of choice potentially available to all WPW patients. […] Long-term results from registry studies demonstrated that there is a striking difference in outcomes between ablated and nonablated patients. […] A recent meta-analysis showed that an RF catheter ablation of WPW has a >94% success rate, a recurrence rate of 6.2%, with a complication rate of 1%. […] In the long term, successful WPW ablation is associated with reduced mortality (due to SCD prevention, as well as reduced risk of heart failure). […] Radiofrequency ablation has drastically changed the management of pre-excitation syndromes. Taking into account the high success rate and low incidence of complications, mostly with low impact on quality of life, this curative procedure should be considered, even in asymptomatic patients.

• #4 Wolff-Parkinson-White Syndrome: Symptoms, Treatment, More

  https://www.healthline.com/health/arrhythmia/wolff-parkinson-white-syndrome

  WPW syndrome is a common cause of a type of heart arrhythmia called paroxysmal supraventricular tachycardia. Its a type of fast heart rhythm that comes and goes. […] Asymptomatic WPW syndrome doesnt necessarily require treatment, but you will need to visit a doctor for regular checkups. […] However, if you do have symptoms, a doctor may recommend certain treatments based on the severity and frequency of your symptoms. […] Some treatments and lifestyle changes may help prevent future WPW syndrome episodes. These include: undergoing catheter ablation, a potentially curative procedure and the most common treatment for WPW syndrome, works to destroy the extra heart muscle fiber; taking antiarrhythmic drugs, such as amiodarone (Pacerone, Nexterone), procainamide (Pronestyl), sotalol (Betapace, Sorine), dofetilide (Tikosyn); avoiding high amounts of caffeine or alcohol; making exercise modifications, as more strenuous workouts can contribute to WPW syndrome symptoms; managing stress.

• #4 Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/wolff-parkinson-white-syndrome-wpw-syndrome

  If ablation cannot be performed or if the patient declines ablation, medical therapy may be accomplished with almost any oral antiarrhythmic medication other than digoxin. Class IIa recommendations are given for oral flecainide or oral propafenone in the absence of a structural heart disorder. Class IIb recommendations are given for oral dofetilide, oral sotalol, and oral amiodarone. […] Although a class IIb recommendation is given for oral beta blockers (especially useful if symptoms occur with exercise), oral diltiazem, or oral verapamil, there is a small possibility that these mediations could be harmful should atrial fibrillation ever occur.

• #4 Wolff Parkinson White Syndrome – The Cardiology Advisor

  https://www.thecardiologyadvisor.com/ddi/wolff-parkinson-white-syndrome/

  In the case of long-term oral medication, it is recommended to use drugs that impede conduction through accessory pathways (e.g. class IA, IC or III agents). Sodium channel blockers (class IA and IC antiarrhythmics) and certain class III antiarrhythmic medications are particularly effective in slowing down conduction as well as prolonging the refractory period of accessory pathways and atrioventricular node; thus, they are considered optimal for this particular condition. […] Digitalis, beta blockers, and calcium channel blockers are effective in inhibiting conduction through the AV node; however, they do not impede conduction over most accessory pathways. On the contrary, these drugs may actually reduce the refractory period of an accessory pathway which could lead to a faster ventricular rate (and a risk of hemodynamic collapse) if administered to individuals suffering from WPW syndrome who experience atrial flutter.

• #4 Wolff-Parkinson-White Syndrome (WPW) | UpBeat.org – powered by the Heart Rhythm Society

  https://upbeat.org/pediatrics/wolff-parkinson-white-syndrome-wpw

  Treatment may include medication to prevent SVT. In babies, medication is given to prevent SVT for the first year. Up to 2/3 of babies will „outgrow” WPW when diagnosed at an early age (in the first year of life) and will not require further treatment. […] Cardiac (heart) ablation has become the first line of treatment in older patients, especially in older children or adults.

• #4

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abo7611

  Your doctor may prescribe medicines to help slow down your heartbeat. […] Your doctor may also suggest you try vagal manoeuvres when having an episode of WPW. […] In some cases, a procedure called catheter ablation is done. […] Be safe with medicines. Take your medicines exactly as prescribed. […] If your doctor showed you how to do vagal manoeuvres, try them when you have an episode. […] Do not use over-the-counter decongestants, diet pills, or „pep” pills. […] If you need help quitting, talk to your doctor about stop-smoking programs and medicines.

• #5 Wolff-Parkinson-White Syndrome: What Treatment?

  https://www.patientcareonline.com/view/wolff-parkinson-white-syndrome-what-treatment

  WPW syndrome is the most common type of ventricular preexcitation syndrome. […] Treatment is not necessary for patients with asymptomatic preexcitation or infrequent, asymptomatic tachycardias. Acute management of symptomatic or persistent tachycardias depends on the underlying mechanism. […] Patients with WPW syndrome associated with atrial fibrillation or flutter should be treated only with procainamide or cardioversion. Ibutilide, a newer agent, has also shown promise in these patients. […] Drugs, surgery, and radiofrequency ablation have been used to prevent the recurrence of tachycardia in patients with WPW syndrome. Medical therapy (with the same agents used for acute management) may be appropriate for patients who have infrequent symptoms. However, because the long-term efficacy and side effects of these medications in patients with WPW syndrome are unknown, ablation has become more widely used. Surgical ablation offers an almost 100% cure rate. However, radiofrequency ablation is less invasive, more cost-effective, and almost as successful, with cure rates ranging from 90% to 95%. The complication rate of radiofrequency ablation is 2.1% and the mortality rate is 0.1% to 0.3%.

• #5 Atrial Fibrillation and Wolff-Parkinson-White Syndrome (WPW Syndrome) – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/specific-cardiac-arrhythmias/atrial-fibrillation-and-wolff-parkinson-white-syndrome-wpw-syndrome

  The treatment of choice for Wolff-Parkinson-White syndrome with atrial fibrillation is direct current cardioversion (1). The usual rate-slowing medications used in atrial fibrillation are not effective, and digoxin, adenosine, and the nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) that may be used in many other forms of supraventricular tachycardia are contraindicated because they may increase the ventricular rate and cause ventricular fibrillation. […] If cardioversion is impossible, medications that prolong the refractory period of the accessory connection should be used. IV procainamide or ibutilide is preferred (1), but any class Ia, class Ic, or class III antiarrhythmic medication can be used. […] Do not give digoxin, adenosine, or nondihydropyridine calcium channel blockers (eg, verapamil, diltiazem) to patients with atrial fibrillation and Wolff-Parkinson-White syndrome because these medications may trigger ventricular fibrillation.

• #5 Wolff-Parkinson-White Syndrome Treatment & Management: Approach Considerations, Initial Management, Pharmacologic Therapy

  https://emedicine.medscape.com/article/159222-treatment

  RF ablation is indicated in the following patients: Patients with symptomatic atrioventricular reentrant tachycardia (AVRT); Patients with AF or other atrial tachyarrhythmias that have rapid ventricular response via an AP (preexcited AF); Patients with AVRT or AF with rapid ventricular rates found incidentally during EPS for unrelated dysrhythmia, if the shortest preexcited RR interval during AF is less than 250 ms; Asymptomatic patients with ventricular preexcitation whose livelihood, profession, insurability, or mental well-being may be influenced by unpredictable tachyarrhythmias or in whom such tachyarrhythmias would endanger the public safety; Patients with WPW and a family history of SCD. […] Symptomatic individuals with orthodromic tachycardia should undergo risk assessment and should be offered therapy according to their symptoms. RF ablation can be curative and carried out with a high degree of success, a low complication rate, and a low recurrence rate.

• #5 Wolff Parkinson White Syndrome – The Cardiology Advisor

  https://www.cancertherapyadvisor.com/home/decision-support-in-medicine/cardiology/wolff-parkinson-white-syndrome-diagnosis-and-treatment/

  In the case of long-term oral medication, it is recommended to use drugs that impede conduction through accessory pathways (e.g. class IA, IC or III agents). Sodium channel blockers (class IA and IC antiarrhythmics) and certain class III antiarrhythmic medications are particularly effective in slowing down conduction as well as prolonging the refractory period of accessory pathways and atrioventricular node; thus, they are considered optimal for this particular condition. […] Digitalis, beta blockers, and calcium channel blockers are effective in inhibiting conduction through the AV node; however, they do not impede conduction over most accessory pathways. On the contrary, these drugs may actually reduce the refractory period of an accessory pathway which could lead to a faster ventricular rate (and a risk of hemodynamic collapse) if administered to individuals suffering from WPW syndrome who experience atrial flutter.

• #6 Wolff-Parkinson-White (WPW) Syndrome | Doctor

  https://patient.info/doctor/wolff-parkinson-white-syndrome-pro

  Patients who present with tachyarrhythmic symptoms may require drug therapy to prevent further episodes and while awaiting definitive treatment – this may also be a long-term option for those in whom ablation or surgery are contraindicated, or not wanted. […] Digoxin is contra-indicated in patients with WPW syndrome. Most deaths from WPW syndrome have been associated with digoxin use. […] RF ablation is increasingly being used both in common types of arrhythmia and selected asymptomatic patients, with a 95% success rate. […] This is now first-line management, ahead of open-heart surgical disconnection and cardiac pacing. […] Indications for RF ablation include: Patients with symptomatic AV re-entrant tachycardia. […] Surgical ablation may still be indicated for patients in whom RF ablation has failed, those who need heart surgery for other reasons and for those patients with multifocal abnormalities requiring surgical ablation (rare).

• #6 Asymptomatic Ventricular Preexcitation (Wolff-Parkinson-White Pattern): When to Be Concerned

  https://www.acc.org/Latest-in-Cardiology/Articles/2022/02/17/13/25/Asymptomatic-Ventricular-Preexcitation

  A significant proportion of patients with ventricular preexcitation remain asymptomatic yet at the risk of life-threatening arrhythmias. […] Shared-decision making must be performed before offering catheter ablation. […] The management of these patients remains controversial. […] One meta-analysis estimated the overall lifetime risk of SCD in asymptomatic WPW patients to 3-4%, with most cases between ages 10 and 40 years. […] Accurate identification of high-risk features for SCD can help prevent this dreaded outcome. […] Noninvasive testing is generally considered safe and should be considered in asymptomatic WPW patients. […] Catheter ablation techniques and experience have improved the safety profile of the procedure. Essentially, catheter ablation can potentially cure WPW syndrome, thereby eliminating the risk of SCD associated with VPE. However, debate remains around when and whether ablation should be performed in asymptomatic WPW patients. […] In general, if an AP contributes to a clinical arrhythmia, if any high-risk feature is present, or if there are multiple APs, then catheter ablation is recommended. […] Prophylactic catheter ablation is reasonable for asymptomatic patients with high-risk features.

Zobacz więcej