Wolff-Parkinson-White syndrome: features of pathogenesis, diagnosis and catheter ablation

Wolff-Parkinson-White syndrome is the second most common cause of supraventricular tachyarrhythmias worldwide. This disease is characterized by combination of typical ECG pattern, ventricular preexcitation and tachyarrhythmias. Morphological substrate is additional muscle bundle outside the specialized area of atrioventricular junction conducting impulses from the atria to the ventricles. Spontaneous propagation of additional impulses can cause paroxysmal arrhythmias, in particular, in children. Additional pathways for conduction of impulses can disrupt functional contraction of the heart and provoke premature contractions up to atrial fibrillation. The last situation is critical. Wolff-Parkinson-White syndrome is characterized by episodic dizziness, pre-syncope, fainting, feelings of «flutter», «silence» of the heart, or even its arrest. This syndrome may not be clinically manifested, but 0.6% of patients annually experience sudden cardiac death. The purpose of this study was to analyze radiofrequency ablation in the treatment of Wolff-Parkinson-White syndrome. This is a method of radical treatment of cardiac impulse conduction disorders. Short-term radiofrequency exposure provokes tissue destruction due to thermal effect. This interrupts the mechanism of additional stimulation and normalizes heart work. Surely, this improves the patient’s quality of life. Surgical intervention is preceded by electrophysiological analysis for mapping of abnormal centers of impulse generation, as well as conduction pathways. This procedure is valuable for ablation with maximum potential efficiency and no possible complications (gas microexplosion, tissue overheating). Ablation normalizes heart rate and eliminates symptoms of arrhythmia. The immediate success rate is 80-98%. In long-term period, recurrence rate is 5-10% and associated with regeneration of abnormal tissues.