ABORTED SUDDEN-DEATH IN THE WOLFF-PARKINSON-WHITE SYNDROME

In a population of 690 patients with Wolff-Parkinson-White (WPW) syndr ome referred to our hospital from January 1979 to February 1995, 15 pa tients (2.2%) had an aborted sudden death out of the hospital. This re trospective study examines their clinical and electrophysiologic chara cteristics. Gender, accessory pathway localization, and presence of mu ltiple accessory pathways were compared between patients with and with out spontaneous ventricular fibrillation (VF). Whereas gender and the presence of multiple accessory pathways did not significantly differ b etween both groups, septally located pathways occurred significantly m ore often in the VF group. In patients with aborted sudden death, spon taneous VF was found significantly more often in men (13 of 15). VF wa s the first manifestation of the WPW syndrome in 8 patients. The remai ning 7 patients had documented episodes of atrial fibrillation, circus movement tachycardia, or both (n = 2). Ten of the 15 patients were ex ercising or under emotional stress at the time of aborted sudden death . Only 1 patient had 2 accessory pathways. The location of the accesso ry pathway was septal (midseptal or pasteroseptal) in 11 patients, lef t lateral in 4, and right lateral in 1.