The Wolff-Parkinson-White pattern in routine electrocardiography.

Fifteen thousand consecutive electrocardiograms on R.C.A.F. aircrew applicants aged 18 to 24 were studied from the standpoint of incidence, clinical findings and follow-up of the WPW pattern discovered because the ECG was taken as part of the selection procedure. Forty-six cases were discovered (0.3%). All were reviewed and passed as clinically fit except for one with asymptomatic rheumatic heart disease. Two others gave a history suggestive of paroxysmal rapid heart action. None of the 43 men on follow-up have developed evidence of arrhythmia. Thirteen of the 46 showed an intermittent pattern initially or on subsequent follow-up. Fifty to 80% of people with the WPW pattern experience tachycardia, according to the literature. The incidence of tachycardia in this study was much lower (2 in 46 or 4.3%). The WPW pattern is not synonymous with the WPW syndrome, and iatrogenic heart disease must be avoided in fit young men in whom the WPW pattern is discovered because of routine electrocardiography.