NON INVASIVE TESTS IN THE EVALUATION AND PROGNOSIS OF WPW SYNDROME
Introduction: WPW syndrome is one of the disorders which affect the conduction system. Its incidence is of 0.1-0.3% and it can have sudden death as a complication. Electrophysiological study is not widely available, that’s why we considered important to evaluate the utility of the others methods, noninvasive, in the appreciation of the characteristic and prognostic of accessory pathways.
Methods: In this study were included 30 patients with WPW syndrome on the rest electrocardiogram. To all this patient we made a stress test and a baseline Holter ECG monitorization. Half of these patients had made, at the beginning a electrophysiological study. The patients were clinically reevaluated and by Holter ECG monitoring after 1 year for the occurrence of rhythm disturbances.
Results: The mean age of the patient was 27+/-4 years. The great majority (56,6) of the patients with pre-excitation syndrome type WPW had at the stress test a evolution with progressive disappearance of delta wave.
All the patients who had delta wave that maintained unmodified during stress test also had permanent pre-excitation at Holter monitoring. The same aspect was observed at the majority of those with progressive disappearance of delta wave.
These patients, with low arrhythmic risk, didn’t have atrial fibrillation, nor at the first evaluation and also not at 1 year evaluation time.
From those 24 patients who had no atrial fibrillation during stress test, this appeared just at one patient during Holter monitoring, and from those 6 patients who presented atrial fibrillation during stress test, just one of them presented atrial fibrillation during Holter monitoring
In conclusion: we can say that noninvasive tests can give enough information regarding the benignity of accessory pathway in WPW syndrome.
Stress test is more sensitive than Holter ECG for selection of the patients with WPW syndrome with low risk of atrial fibrillation development.