When is the transfer to a tertiary facility for comprehensive evaluation and management indicated 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

Certain patients with WPW syndrome must be transferred to a tertiary facility for comprehensive evaluation and management by a cardiac electrophysiologist, which may include EPS or ablative therapy. Such patients include those presenting with any of the following:

  • SCD
  • Syncope
  • Significant symptomatic tachyarrhythmias
  • Uncertain diagnosis (in those with wide-complex tachycardia)
  • Associated structural heart disease (eg, Ebstein anomaly, cardiomyopathy, mitral valve prolapsed)
  • A family history of SCD
  • No symptoms, but are working in professions in which spontaneous occurrence of tachyarrhythmia may jeopardize public safety, cause much mental anguish, or influence insurability
  • AF or atrial flutter

Ideally, if transfer of patients with WPW syndrome and other causes of SVT is indicated, they undergo conversion of their rhythm in the referring institution and are transferred in sinus rhythm.


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