[II-TSPCJS1-01] Catheter ablation for asymptomatic WPW syndrome
Background: PACES/HRS have announced the expert consensus statement on the management of the asymptomatic WPW syndrome, in which we should evaluate the risk of syncope or tachycardia. There have been many asymptomatic patients in Japan because of the school ECG screening. This study aimed to clarify the characteristics of asymptomatic WPW patients. Methods: One hundred thirty-seven children having WPW syndrome without structural heart diseases who underwent the catheter ablation between 2011 and 2023 were included. We defined the patients without tachycardia, syncope, or cardiac dysfunction as symptomatic. The location of accessory pathway (AP), the success rate, complications, and the indication of the catheter ablation were analyzed. The ablation was recommended when they had ventriculo-atrial conduction via AP, one echo beat via AP, atrioventricular reciprocating tachycardia (AVRT), or the refractory period (ERP) of AP less than 250 ms in the electrophysiological study (EPS). Results: Fifty-three patients (38%) were asymptomatic. The locations of AP were left, right, and septum in 55%, 20%, and 23%, respectively in symptomatic pts, and in 30%, 34%, and 36%, respectively, in asymptomatic pts. The acute success, recurrence, and complication were 98%, 4%, and 0%, respectively. The indication of catheter ablation were EPS findings in 41 (77%) (short APERP in 5), and patient choice in 11. Conclusions: About 80% % of asymptomatic patients had the risk of AVRT or rapid conduction of AF over AP. The result of catheter ablation for asymptomatic WPW patients was favorable. Right and septal APs were more frequent in asymptomatic pts than in symptomatic pts. We should give enough explanation to the patients or their parents for the complication and the recurrences.