Sudden cardiac death in the Wolff-Parkinson-White syndrome

Sudden death in the Wolff-Parkinson-White syndrome is an uncommon event but strikes in otherwise healthy children or young adults, often without much warning. They tend to occur in symptomatic but have also been reported in asymptomatic individuals. Several studies have been done profiling the sudden death survivor in the Wolff-Parkinson-White syndrome. In general, they tend to be symptomatic, have a short RR interval between preexcited beats during atrial fibrillation, have multiple pathways and may be associated with familial occurrence and Ebstein's anomaly. Several noninvasive investigations can help to assess the risk for sudden death, but the gold standard remains the use of electrophysiological testing. The management of patients with documented ventricular fibrillation or resuscitation from sudden death is unquestionably ablation of the accessory pathway but for the asymptomatic patients, it is still controversial whether they should be routinely studied by electrophysiological studies.