Date of Award
Master of Physician Assistant Studies (MPAS)
Physician Assistant Studies
Wolff-Parkinson-White; Ventricular Peexcitation; Radiofrequency Catheter Ablation, Accessory Pathway; Sudden Cardiac Death
Wolff-Parkinson-White (WPW) is a condition in which an accessory conduction pathway exists within the heart. This accessory pathway may or may not cause symptoms, in fact, the first manifestation of the condition may be sudden cardiac death. The management of this condition in asymptomatic individuals is controversial. The purpose of this research and literature review is to analyze the safety and efficacy associated with invasive catheter ablation of the accessory pathway, in comparison to risk of sudden cardiac death and malignant arrythmias in non-ablated, asymptomatic individuals with WPW. In this review, five databases were searched including CINAHL, Clinical Key, PubMed, Cochrane Library, and Dynamed Plus. Both keyword and mesh terms were used to define a set of the literature discussing Wolff-Parkinson-White, ventricular preexcitation, radiofrequency catheter ablation, and sudden cardiac death. Works chosen for review were published from 2009 to 2019, and included surveys, case control studies, and cohort studies. Sources that were excluded included those published prior to 2009, systematic reviews, and meta-analysis, in order to exclusively include original research. Much of the research suggests that electrophysiologists do not currently have an adequate evidence-based recommendation for the management of the asymptomatic patient with WPW. The methodology and safety of the ablation procedures may have evolved over time, making it difficult with the current data available to conclude the safety and efficacy of modern radiofrequency catheter ablation. Research also appears to be lacking longitudinal studies analyzing the outcomes of the non-ablated individuals. Future research is necessary to develop a guideline to direct decision to ablate the asymptomatic patient according to predetermined criteria and patient factors.
Mondry, Erin BreAnn, "Catheter Ablation of the Accessory Pathway in the Asymptomatic Patient with Wolff-Parkinson-White" (2020). Physician Assistant Scholarly Project Papers. 78.