What are risk factors for sudden cardiac death (SCD) in Wolff-Parkinson-White (WPW) syndrome?

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

Even in patients with asymptomatic WPW, the risk of SCD is increased above that of the general population. Medical therapy with agents such as digoxin may increase this risk if the patient has AF or atrial flutter by favoring atrial-to-ventricular conduction over the bypass tract rather than the AV node. The risk in asymptomatic patients is low and can be reduced further with prophylactic catheter ablation of the accessory pathway (EPS and RF ablation).

Other factors that appear to influence the risk of SCD are the presence of multiple bypass tracts, short AP refractory periods (<240 ms), AF and atrial flutter, or a family history of premature sudden death. SCD is unusual without preceding symptoms.


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