Although diagnostic assessment and treatment have been described in detail in patients with symptomatic Wolff-Parkinson-White (WPW) syndrome, the management of asymptomatic subjects remains controversial. Usually they are assumed to have a benign prognosis, although they do very occasionally present with ventricular fibrillation (VF) as the first manifestation of the syndrome. Discovering a WPW pattern in a previously asymptomatic athlete on a routine electrocardiogram (ECG) identifies the necessity for more accurate screening tests. However, non-invasive methods (Holter monitoring, exercise treadmill testing) seem to be relatively incomplete for risk stratification, especially for athletes. Current guidelines do not always recommend a routine electrophysiological study (EPS) in patients with an asymptomatic WPW ECG pattern, especially in children younger than 12 years. Individuals who engage in high-risk occupations or those patients who have a pre-excitation pattern which precludes them from following their chosen career or activities may be exceptions. The presence of inducible reciprocating tachycardia during EPS, especially when it triggers atrial fibrillation with short RR interval, can represent a specific risk marker of dangerous arrhythmias.

译文

:尽管对有症状的沃尔夫-帕金森-怀特(WPW)综合征患者进行了详细的诊断评估和治疗,但无症状患者的治疗仍存在争议。通常认为它们预后良好,尽管偶尔会出现室颤(VF)作为该综合征的首发表现。在常规心电图(ECG)上发现以前没有症状的运动员中的WPW模式可确定进行更准确筛查测试的必要性。但是,对于风险分层,非侵入性方法(动态心电图监测,运动跑步机测试)似乎相对不完整,尤其是对于运动员而言。当前的指南并不总是建议对无症状WPW ECG模式的患者进行常规电生理研究(EPS),尤其是对于12岁以下的儿童。从事高风险职业的个人或具有预激励模式的患者可能会例外,因为这种模式会阻止他们从事自己选择的职业或活动。 EPS期间存在可诱导的往复性心动过速,特别是当它以短的RR间隔触发房颤时,可能是危险性心律失常的特定危险标志。

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