What are the PACES/HRS treatment guidelines for asymptomatic Wolff-Parkinson-White (WPW) syndrome in patients aged 8-21 years old?

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

The guidelines include the following management recommendations in asymptomatic patients aged 8-21 years with WPW [17] :

  • For those with a shortest preexcited RR interval (SPERRI) of 250 ms or less in AF, consider catheter ablation and factor in the associated procedural risk factors on the basis of the AP anatomic site.
  • Consider catheter ablation also for those with concomitant (1) structural heart disease, regardless of the anterograde AP features, or (2) ventricular dysfunction due to dyssynchronous contractions, regardless of the anterograde bypass tract characteristics.
  • Previously asymptomatic patients who develop cardiovascular (CV) symptoms should be considered symptomatic and thus potential candidates for catheter ablation.
  • For those with a SPERRI longer than 250 ms in AF, consider deferring catheter ablation.
  • Consider administration of attention-deficit/hyperactivity disorder (ADHD) medications; if ADHD medications are used, closely monitor patients for CV symptoms.

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