New approaches to the management of the Wolff Parkinson White syndrome

Pre excitation has been defined as 'a condition in which all or some portion of the ventricular muscle is activated earlier in relation to atrial events, than would be expected had the impulse reached the ventricle by way of the normal atrioventricular conduction system'. The susceptibility of patients with pre excitation to paroxysmal tachycardias had been described many years previously. The Wolff Parkinson White syndrome was initially thought to have a relatively benign prognosis. Subsequently, it was recognized that some patients were prone to life threatening arrhythmias and sudden death. This recognition has given impetus to sophisticated electrophysiological study of the pre excitation syndromes by recently developed techniques of catheterisation, epicardial mapping and surgery. The purpose of this review is to highlight the recent advances in management of the Wolff Parkinson White syndrome which have been based upon these electrophysiological techniques.