The asymptomatic patient with the Wolff-Parkinson-White electrocardiogram

Pacing Clin Electrophysiol. 1997 Aug;20(8 Pt 2):2082-6. doi: 10.1111/j.1540-8159.1997.tb03633.x.


Sudden death can be the first manifestation of the Wolff-Parkinson-White (WPW) syndrome. The underlying mechanism being atrial fibrillation with a very high ventricular rate, because of a short anterograde refractory period of the accessory atrioventricular pathway (AP), deteriorating into ventricular fibrillation. Information on the anterograde refractory period of the AP is therefore important to recognize asymptomatic people with the WPW ECG at risk for dying suddenly. Several noninvasive tests are available to identify the low risk patient. Decision making when to interrupt the AP in asymptomatic WPW patients not at low risk requires an invasive study to document the electrophysiological properties of the AP and to determine its exact location.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Atrial Fibrillation / etiology
  • Atrioventricular Node / pathology
  • Atrioventricular Node / physiopathology
  • Atrioventricular Node / surgery
  • Catheter Ablation
  • Child
  • Death, Sudden, Cardiac / etiology
  • Decision Making
  • Electrocardiography*
  • Heart Ventricles / physiopathology
  • Humans
  • Middle Aged
  • Refractory Period, Electrophysiological
  • Risk Factors
  • Ventricular Fibrillation / etiology
  • Wolff-Parkinson-White Syndrome / complications
  • Wolff-Parkinson-White Syndrome / physiopathology*
  • Wolff-Parkinson-White Syndrome / surgery