Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (839 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A form of ventricular pre-excitation characterized by a short PR interval and a long QRS interval with a delta wave. In this syndrome, atrial impulses are abnormally conducted to the heart ventricles via an accessory conducting pathway that is located between the wall of the right or left atria and the ventricles, also known as a bundle OF KENT. The inherited form can be caused by mutation of prkag2 gene encoding a gamma-2 regulatory subunit of AMP-activated protein kinase.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Syndrome, Wolff-Parkinson-White; Wolff Parkinson White Syndrome; Anomalous Ventricular Excitation Syndrome; Auriculoventricular Accessory Pathway Syndrome; False Bundle-Branch Block Syndrome; Ventricular Pre-Excitation with Arrhythmia; Wolf-Parkinson-White Syndrome; Syndrome, Wolf-Parkinson-White.
Where it fits in the MeSH classification
- Broader topics
- Pre-Excitation Syndromes; Heart Defects, Congenital
Related concepts
- Heart Ventricles
- Accessory Conducting Pathway
- Bundle
- Prkag2
Research landscape
PubMed indexes 5,750 records tagged with the MeSH heading “Wolff-Parkinson-White Syndrome” (counts retrieved 2026-10-29). 250 of them (4.3%) were published from 2020 onward, and the busiest period so far is through 1999 with 4,249 records.
Reviews account for 496 records (8.6%) and meta-analyses for 5. Randomized controlled trials number 26 (0.5%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 4,249 |
| 2000-2009 | 687 |
| 2010-2019 | 564 |
| 2020 onward | 250 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 496 | 8.6% |
| Meta-analyses | 5 | 0.1% |
| Randomized controlled trials | 26 | 0.5% |
Method: PubMed query "Wolff-Parkinson-White Syndrome"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in rare and inherited diseases
Rare conditions are difficult to study: few patients means small studies, case reports and registries are common, and randomized trials are the exception. Small samples limit precision and can exaggerate effects, and cases reported in the literature may be the most severe or unusual. Evidence from many small studies is best read together. Check how patients were identified, how many were included and how long they were followed.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Cardiac manifestations of PRKAG2 mutation | 2018 | Research article Design not recorded in structured metadata | 24 | cc by PMID 29298659 · DOI · PMC5751825 |
| Accessory pathway analysis using a multimodal deep learning model | 2021 | Research article Design not recorded in structured metadata | 23 | cc by PMID 33850245 · DOI · PMC8044112 |
| Risk assessment in patients with symptomatic and asymptomatic pre-excitation | 2024 | Research article Design not recorded in structured metadata | 19 | cc by PMID 38363996 · DOI · PMC10873488 |
| Association Between Atrial Fibrillation Occurrence and Wolff-Parkinson-White Syndrome: Is Prediction Possible? | 2026 | Research article Design not recorded in structured metadata | 1 | cc by PMID 42484212 · DOI · PMC13399060 |
Cardiac manifestations of PRKAG2 mutation [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundThe Protein Kinase AMP-Activated Non-Catalytic Subunit Gamma 2 (PRKAG2) cardiac syndrome is characterized by glycogen accumulation in the cardiac tissue.
- Closing excerpt
- Patients presenting with conduction abnormalities and suspected HCM should be considered for genetic testing to identify possible underlying genetic etiologies.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (154 words)
BackgroundThe Protein Kinase AMP-Activated Non-Catalytic Subunit Gamma 2 (PRKAG2) cardiac syndrome is characterized by glycogen accumulation in the cardiac tissue. The disease presents clinically with hypertrophic cardiomyopathy (HCM), and it is often associated with conduction abnormalities.Case presentationA 23 year-old female with history of Wolff-Parkinson-White (WPW) and HCM presented for evaluation after an episode of Non-ST Elevation Myocardial Infarction (NSTEMI). The patient was found to have severe coronary bridging on angiography and underwent an unroofing of the left anterior descending artery (LAD). Due to the constellation of symptoms, the patient underwent genetic testing and a cardiac muscle biopsy. Genetic testing was significant for an Arg302Gln mutation in the PRKAG2 gene. Cardiac tissue biopsy revealed significant myocyte hypertrophy and large vacuoles with glycogen stores.ConclusionThe pathologic and genetics findings of our patient are consistent with PRKAG2 syndrome. Patients presenting with conduction abnormalities and suspected HCM should be considered for genetic testing to identify possible underlying genetic etiologies.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29298659 · DOI · PMC5751825
Accessory pathway analysis using a multimodal deep learning model [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Cardiac accessory pathways (APs) in Wolff-Parkinson-White (WPW) syndrome are conventionally diagnosed with decision tree algorithms; however, there are problems with clinical usage.
- Closing excerpt
- Deep learning with a combination of ECG and chest X-ray data could effectively identify the AP location, which may be a novel deep learning model for a multimodal model.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (191 words)
Cardiac accessory pathways (APs) in Wolff-Parkinson-White (WPW) syndrome are conventionally diagnosed with decision tree algorithms; however, there are problems with clinical usage. We assessed the efficacy of the artificial intelligence model using electrocardiography (ECG) and chest X-rays to identify the location of APs. We retrospectively used ECG and chest X-rays to analyse 206 patients with WPW syndrome. Each AP location was defined by an electrophysiological study and divided into four classifications. We developed a deep learning model to classify AP locations and compared the accuracy with that of conventional algorithms. Moreover, 1519 chest X-ray samples from other datasets were used for prior learning, and the combined chest X-ray image and ECG data were put into the previous model to evaluate whether the accuracy improved. The convolutional neural network (CNN) model using ECG data was significantly more accurate than the conventional tree algorithm. In the multimodal model, which implemented input from the combined ECG and chest X-ray data, the accuracy was significantly improved. Deep learning with a combination of ECG and chest X-ray data could effectively identify the AP location, which may be a novel deep learning model for a multimodal model.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33850245 · DOI · PMC8044112
Risk assessment in patients with symptomatic and asymptomatic pre-excitation [3]
Abstract reading summary — source excerpts
- Opening excerpt
- AimsControversy remains as to whether the exercise stress test (EST) is sufficient for risk evaluation in patients with pre-excitation.
- Closing excerpt
- gov Identifier: NCT03301935).
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (255 words)
AimsControversy remains as to whether the exercise stress test (EST) is sufficient for risk evaluation in patients with pre-excitation. This study aims to clarify the usefulness of EST in risk stratification in both asymptomatic and symptomatic patients presenting with pre-excitation.Methods and resultsThis prospective study includes consecutive asymptomatic and symptomatic patients with pre-excitation referred for risk assessment. All participants performed an incremental EST (bicycle) prior to an electrophysiology study (EPS). Primary data from the EST included loss of pre-excitation during exercise, and primary data from the EPS included the measurement of accessory pathway effective refractory period (APERP), shortest pre-excited RR interval (SPERRI), and inducible arrhythmia with the use of a beta-adrenergic receptor agonist if deemed necessary. One hundred and sixty-four patients (59 asymptomatic, 105 symptomatic) completed an EST and EPS. Forty-five patients (27%) demonstrated low-risk findings on EST, of which 19 were asymptomatic and 26 were symptomatic. Six patients with low-risk EST findings had SPERRI/APERP ≤ 250 ms at EPS, and two of them were asymptomatic. The sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy of low-risk EST for excluding patients with SPERRI/APERP ≤ 250 ms were 40, 91, 87, 51, and 60%, respectively. The number of patients with inducible arrhythmia at EPS was similar in the asymptomatic (36, 69%) and symptomatic (73, 61%) groups.ConclusionSudden loss of pre-excitation during EST has a low NPV in excluding high-risk APs. The EPS with the use of isoproterenol should be considered to accurately assess the risk of patients with pre-excitation regardless of symptoms (ClinicalTrials.gov Identifier: NCT03301935).
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 38363996 · DOI · PMC10873488
Association Between Atrial Fibrillation Occurrence and Wolff-Parkinson-White Syndrome: Is Prediction Possible? [4]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundPatients with Wolff-Parkinson-White (WPW) syndrome frequently develop atrial fibrillation (AF); however, the factors associated with the occurrence of AF remain incompletely defined.
- Closing excerpt
- In contrast, posterior AP location and male sex were associated with a greater likelihood of EPS-induced AF.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (239 words)
BackgroundPatients with Wolff-Parkinson-White (WPW) syndrome frequently develop atrial fibrillation (AF); however, the factors associated with the occurrence of AF remain incompletely defined.ObjectivesTo evaluate the prevalence and associated factors of clinical AF and electrophysiological study (EPS)-induced AF in a large consecutive cohort of patients with WPW undergoing accessory pathway (AP) ablation.MethodsThis retrospective analysis included 845 consecutive patients with WPW who underwent AP ablation at a single tertiary referral center. A standardized EPS protocol was applied throughout the study period. Study outcomes included clinical AF (documented by medical history or monitoring before EPS), EPS-induced AF, and any AF (composite outcome). Multivariable logistic regression models were used to estimate adjusted odds ratio (ORa) with 95% CIs. Statistical significance was set at p ResultsMean age was 33.2 ± 15.9 years, and 486 of 845 patients (57.5%) were male. Multiple APs were identified in 31 patients (3.7%). The most common AP locations were left lateral (327/845, 38.7%) and posterior (323/845, 38.2%). Clinical AF was present in 109 patients (12.9%), EPS-induced AF in 77 (9.1%), and any AF in 168 (19.9%). In multivariable analyses, a left lateral AP was independently associated with clinical AF (ORa, 2.31; 95% CI, 1.53-3.49; p ConclusionIn this large cohort of patients with WPW undergoing AP ablation, left lateral AP location and older age were independently associated with a higher prevalence of clinical AF. In contrast, posterior AP location and male sex were associated with a greater likelihood of EPS-induced AF.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42484212 · DOI · PMC13399060
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary. A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation): developed in Collaboration With the North American Society of Pacing and Electrophysiology [5]
- Research article PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS) [6]
- Research article Tumors metastatic to the heart [7]
- Research article Risk of arrhythmia and sudden death in patients with asymptomatic preexcitation: a meta-analysis [8]
- Research article Clinical Spectrum of PRKAG2 Syndrome [9]
- Research article Epicardial mapping in the Wolff-Parkinson-White syndrome [10]
References
- Banankhah P, Fishbein GA, Dota A, Ardehali R. Cardiac manifestations of PRKAG2 mutation. . 2018. PMID 29298659 · DOI · PMC5751825
- Nishimori M, Kiuchi K, Nishimura K, Kusano K, Yoshida A, Adachi K, et al.. Accessory pathway analysis using a multimodal deep learning model. . 2021. PMID 33850245 · DOI · PMC8044112
- Jemtrén A, Saygi S, Åkerström F, Asaad F, Bourke T, Braunschweig F, et al.. Risk assessment in patients with symptomatic and asymptomatic pre-excitation. . 2024. PMID 38363996 · DOI · PMC10873488
- Mario ADS, Targueta EP, Darrieux FCDC, Brigido ARD, Ferraz AP, Chokr MO, et al.. Association Between Atrial Fibrillation Occurrence and Wolff-Parkinson-White Syndrome: Is Prediction Possible?. . 2026. PMID 42484212 · DOI · PMC13399060
- Fuster V, Rydén LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, et al.. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary. A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation): developed in Collaboration With the North American Society of Pacing and Electrophysiology. J Am Coll Cardiol. 2001. PMID 11583910 · DOI
- Pediatric and Congenital Electrophysiology Society (PACES), Heart Rhythm Society (HRS), American College of Cardiology Foundation (ACCF), American Heart Association (AHA), American Academy of Pediatrics (AAP), Canadian Heart Rhythm Society (CHRS), et al.. PACES/HRS expert consensus statement on the management of the asymptomatic young patient with a Wolff-Parkinson-White (WPW, ventricular preexcitation) electrocardiographic pattern: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology Foundation (ACCF), the American Heart Association (AHA), the American Academy of Pediatrics (AAP), and the Canadian Heart Rhythm Society (CHRS). Heart Rhythm. 2012. PMID 22579340 · DOI
- Goldberg AD, Blankstein R, Padera RF. Tumors metastatic to the heart. Circulation. 2013. PMID 24126323 · DOI
- Obeyesekere MN, Leong-Sit P, Massel D, Manlucu J, Modi S, Krahn AD, et al.. Risk of arrhythmia and sudden death in patients with asymptomatic preexcitation: a meta-analysis. Circulation. 2012. PMID 22532593 · DOI
- Porto AG, Brun F, Severini GM, Losurdo P, Fabris E, Taylor MRG, et al.. Clinical Spectrum of PRKAG2 Syndrome. Circ Arrhythm Electrophysiol. 2016. PMID 26729852 · DOI · PMC4704128
- Gallagher JJ, Kasell J, Sealy WC, Pritchett EL, Wallace AG. Epicardial mapping in the Wolff-Parkinson-White syndrome. Circulation. 1978. PMID 346254 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
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