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. 2020 Jun 15;22(8):1147–1148. doi: 10.1093/europace/euaa065
Patients with supraventricular tachyarrhythmia such as WPW syndrome and focal atrial tachycardia Class References
EPS, with the use of isoprenaline, is recommended to risk stratify individuals with asymptomatic pre-excitation who have high-risk occupations/hobbies, and those who participate in competitive athletics. graphic file with name euaa065ilf1.jpg 514–516
EPS should be considered for risk stratification in asymptomatic pre-excitation patients without high-risk occupations or those who are not competitive athletes. graphic file with name euaa065ilf1.jpg 514 , 516 , 517
Non-invasive screening with exercise testing, drug testing, and ambulatory monitoring may be considered for risk stratification in asymptomatic pre-excitation patients without high-risk occupations or those who are not competitive athletes. graphic file with name euaa065ilf2.jpg 514 , 516 , 517
High-risk features to consider at EPS with or without catecholamine challenge are accessory pathways with an antegrade refractory period ≤250 ms, shortest pre-excited RR interval during AF ≤250 ms, inducible atrioventricular re-entrant tachycardia, and multiple accessory pathways. graphic file with name euaa065ilf2.jpg 514 , 518 , 519
Observation without treatment may be reasonable in asymptomatic WPW patients who are considered to be at low risk following EPS, abrupt loss of pre-excitation during exercise testing, or due to intermittent pre-excitation on a resting ECG or during ambulatory monitoring. graphic file with name euaa065ilf2.jpg 514 , 516