What is the prognosis of Wolff-Parkinson-White (WPW) syndrome in asymptomatic patients with only preexcitation on ECG?

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

Asymptomatic patients with only preexcitation on ECG generally have a very good prognosis. Many develop symptomatic arrhythmias over time, which can be prevented with prophylactic EPS and RF catheter ablation. [16] Patients with a family history of sudden cardiac death (SCD) or significant symptoms of tachyarrhythmias or cardiac arrest have worse prognoses. However, once definitive therapy is performed, including curative ablation, the prognosis is once again excellent.

Noninvasive risk stratification (eg, Holter monitoring, exercise stress test) [17] can be useful if abrupt and complete loss of preexcitation occurs with exercise or procainamide infusion. However, this is not an absolute predictor for the absence of arrhythmic episodes.


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