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Cited by 500Cardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmiasCardiovascular Effects of Exercise

A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, 1953–1989

Munger, T M, Packer, D L, Hammill, S C, Feldman, B J, Bailey, K R, Ballard, D J, Holmes, D R, Gersh, B J·1993·Circulation
DOI 10.1161/01.cir.87.3.866
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Abstract

BACKGROUND: Virtually all natural history studies of Wolff-Parkinson-White (WPW) syndrome have been case series and, as such, have been constrained by referral biases, skewed age and sex distributions, or brief follow-up periods. The purpose of our study was to examine the natural history, the development of arrhythmias, and the incidence of sudden death in an entire cohort of pediatric and adult WPW patients from a community-based local population. METHODS AND RESULTS: We identified 113 residents of Olmsted County, Minnesota, during the period 1953-1989 using the centralized records-linkage system provided by the Mayo Clinic and the Rochester Epidemiology Program Project. Medical records and ECGs were reviewed to confirm the diagnosis and to establish pathway location by ECG criteria. Follow-up, via record review and telephone interview, was complete in 95% of subjects through 1990. The incidence of newly diagnosed cases was approximately four per 100,000 per year. Preexcitation was not present on the initial ECG of 22% of the cohort. Approximately 50% of the population was asymptomatic at diagnosis, with 30% subsequently having symptoms related to arrhythmia at follow-up. Two sudden cardiac deaths (SCD) occurred over 1,338 patient-years of follow-up, yielding an overall SCD rate of 0.0015 (95% confidence interval, 0.0002-0.0054) per patient-year. No SCD occurred in patients asymptomatic at diagnosis. CONCLUSIONS: The incidence of sudden death in a local community-based population is low and suggests that electrophysiological testing should not be performed routinely in asymptomatic patients with WPW syndrome. Nevertheless, young, asymptomatic patients, particularly those < 40 years old, should return for medical follow-up should symptoms develop.

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Authors
Munger, T. M., Packer, D. L., Hammill, S. C., Feldman, B. J., Bailey, K. R., Ballard, D. J., Holmes, D. R., & Gersh, B. J.
Affiliations
Mayo Clinic (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1993-03
Volume
87
Issue
3
Pages
866-873
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.87.3.866
OpenAlex
W1989867460
Cited by
500
References
31
Citations by year
2026: 8 · 2025: 13 · 2024: 12 · 2023: 18 · 2022: 17 · 2021: 9 · 2020: 14 · 2019: 20 · 2018: 19 · 2017: 18 · 2016: 19 · 2015: 36 · 2014: 18 · 2013: 26 · 2012: 33
FWCI
6.91
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5r01hl024326-10)
  • National Heart, Lung, and Blood Institute (HL24326)
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR030582, AR30582)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
Keywords
Wolff-Parkinson-White syndrome, natural history (disease), sudden cardiac death, cardiac arrhythmias, preexcitation, asymptomatic patients, incidence, electrophysiological study, community-based cohort, Olmsted County, Minnesota
MeSH terms
Adolescent, Adult, Aged, Arrhythmias, Cardiac, Child, Child, Preschool, Electrocardiography, Electrophysiology, Female, Follow-Up Studies, Humans, Infant, Male, Middle Aged, Minnesota, Retrospective Studies, Wolff-Parkinson-White Syndrome, Cohort Studies, Incidence, Survival Analysis, Death, Sudden, Cardiac

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