ATRIAL FIBRILLATION IN THE WOLFF-PARKINSON-WHITE SYNDROME

In the Wolff-Parkinson-White syndrome, auricular fibrillation (AF) is the most frequent arrhythmia after reentrant auriculoventricular tachycardia. The preexcited AF can induce hemodynamic collapse and sudden death. This arrhythmia occurs mainly in the third and the fifth decade of life. During AF, the minimum preexcited R-R interval has been associated to the risk of sudden death. This arrhythmia should also been considered as an emergency and it must be treated immediately. If there is no hemodynamic impairment, the selected medication is procainamide; on the contrary, the electric cardioversion in synchronic mode is the right choice. The main controversies on this topic are focused in the management of the asymptomatic patient. The most recent trend is the stratification of the arrhythmic risk by means of an electrophysiologic study. This review will deal with a clinic situation that has not always been well identified; specific epidemiological and electrophysiologic factors of this arrhythmia will be presented, its treatment and some controversies on the topic.