Influence of age on the potential risk of sudden death in asymptomatic Wolff-Parkinson-White syndrome

Sudden death might be the first event in patients with asymptomatic WPW. Th e purpose of the study was to know if the age of the patient modifies the e lectrophysiological characteristics of asymptomatic WPW. Transesophageal st imulation was performed on 92 asymptomatic WPW patients from the following age groups: 10-69 years (n = 14), 20-29 years (n = 33), 30-39 years (n = 15 ), 40-49 years (n = 17), and 50-69 years (n = 13). The procedure consisted of atrial pacing up to the second AV block, programmed atrial stimulation u sing one and two extrastimuli delivered on two driven rhythms in the contro l state, and after infusion of isoproterenol. In the five age groups, parox ysmal junctional tachycardia occurred, respectively, in 1 (7%), 1 (3%), 2 ( 13%), 2 (12%) patients, and not at all in the oldest group. AF > 1 minute o ccurred, respectively, in 3 (21%), 9 (27%), 5 (33%), 3 (18%), and 4 (31%) p atients. The dangerous form of WPW (rapid conduction in the Kent bundle > 2 40/min in the control state or > 300/min after isoproterenol + AF induction ) occurred, respectively, in 3 (21%), 9 (27%), 4 (27%), 1 (6%), and 3 (23%) patients. In conclusion, electrophysiological data of asymptomatic WPW are not modified by age of the patient. Elderly patients remain at risk of a d angerous form of WPW, systematic evaluation of WPW is recommended in patien ts with an active life independent of age.