What is the role of surgical open heart procedures in the treatment of 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

Surgical open-heart procedures were more common before RF ablation was developed. Now, RF catheter ablation has virtually eliminated surgical open heart treatments in the vast majority of patients, with the following exceptions:

  • Patients in whom RF catheter ablation (with repeated attempts) fails [12]
  • Patients undergoing concomitant cardiac surgery (eg, for structural heart disease [12] ) (possible exception)
  • Patients with other tachycardias with multiple foci who require surgical intervention (very rare)

The 2012 Heart Rhythm Society (HRS)/European Heart Rhythm Association (EHRA)/European Cardiac Arrhythmia Society (ECAS) (HRS/EHRA/ECAS) expert consensus statement on catheter and surgical ablation of atrial fibrillation noted that implantable implantable cardioverter-defibrillator (ICD) therapy is not indicated for VF or VT that is amenable to surgical or catheter ablation—such as atrial arrhythmias associated with the WPW syndrome. [3]


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