Wolff-Parkinson-White syndrome and radiofrequency ablation

Wolff-Parkinson-White syndrome is the most common of the preexcitation syndromes and is due to an accessory pathway connecting the atria and ventricles. Asymptomatic patients do not require empirical therapy. Ongoing drug therapy has traditionally been the choice for older symptomatic patients and patients with infrequent symptoms. However, more definitive therapy, ie, surgical or nonsurgical ablation, may be preferable for younger patients, patients with medically refractory arrhythmias, and patients at high risk for sudden death. Ablation by radiofrequency current is now being routinely performed because it appears to be cost-effective and has been found to be safe and efficient if performed by skilled operators. Clinical experience of this procedure is limited, however, and long-term effects still need to be established.