How does the prevalence of Wolff-Parkinson-White (WPW) syndrome vary by age?

Updated: Jan 08, 2017
  • Author: Christopher R Ellis, MD, FACC, FHRS; Chief Editor: Mikhael F El-Chami, MD  more...
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Answer

WPW syndrome is found in persons of all ages. Most patients with WPW syndrome present during infancy. However, a second peak of presentation is noted in school-aged children and in adolescents. This interesting bimodal age distribution is due to permanent or transitory loss of preexcitation during infancy in some patients and during late adolescence in others.

The prevalence of WPW syndrome decreases with age as a consequence of apparent attenuation of conduction speed in the AP. About one fourth of patients lose preexcitation over a 10-year period, probably as a result of fibrotic changes at the site of insertion of the accessory bypass tract with loss of electrical conduction properties between cardiac chambers. Cases have been described in which ECG evidence of preexcitation disappears completely. One tenth of patients with concealed APs lose retrograde conduction over 10 years.

In asymptomatic patients, antegrade conduction across the AP may spontaneously disappear with advancing age (one fourth of patients lose antegrade bypass tract conduction over 10 years).

In patients with abnormal ECG findings indicative of WPW syndrome, the frequency of SVT paroxysms increases from 10% in people aged 20-39 years to 36% in people older than 60 years. [15] Overall, about 50% of patients with WPW develop tachyarrhythmias.


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