Advances in evaluating and treating Wolff-Parkinson-White syndrome

Interest has increased in the use of new noninvasive modalities, particularly body surface mapping, for localizing accessory pathways in Wolff-Parkinson-White syndrome. New data from invasive studies reviewed here include evidence of decremental conduction and the linking phenomenon in patients with accessory pathways. Risk factors for sudden death, including syncope and atrial fibrillation, are reviewed. The most notable advances involve our ability to offer patients catheter ablation, which has proven to be safe and effective. Both direct current and radiofrequency catheter ablation are discussed.