What is your approach to risk stratification of asymptomatic patients with pre-excitation syndrome?
Answer from: at Academic Institution
I like getting a stress test and ambulatory ecg to see how preexcitation is affected by higher heart rates. Many accessory pathways do not have particularly robust conduction antegrade which is the key factor in whether or not atrial fibrillation can lead to life-threatening tachycardia.
When addressing pre-excitation on EKG, some good references include:
ACC online expert analysis
2012 PACES/HRS expert consensus statement
Editorial on the 2012 PACES guidelines about the challenges of being more aggressive
In general, I agree with Dr. @Zunamon and the ACC expert analysis that am...