Prophylactic catheter ablation in asymptomatic adult and pediatric patients with wolff-parkinson-white pattern: a systematic review and meta-analysis

Abstract Introduction The effectiveness of prophylactic catheter ablation (CA) for asymptomatic Wolff-Parkinson-White (WPW) pattern who underwent electrophysiological study remains uncertain. Purpose Evaluate the effectiveness of Prophylactic catheter ablation compared to conservative management in reducing arrhythmia recurrence (AR), sudden death (SD), Ventricular fibrillation (VF), and atrioventricular reentrant tachycardia (AVRT). Methods We searched PubMed, Embase, and the Cochrane Library for studies comparing prophylactic CA to no-CA in asymptomatic adult and pediatric WPW patients. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model for binary endpoints. Heterogeneity was assessed using I² statistics. We utilized R Studio version 4.4.1 for statistical analysis. Results We included 336 patients from five studies, of whom 199 (58,7%) received CA. Prophylactic CA significantly reduced the risk of AR (RR= 0,27; 95%CI 0.09,0.82; p=0.021) compared to no-CA. However, no significant difference in SD (RR 0.33; 95%CI 0.04, 3.10; p=0.33), VF (RR 0.29; 95%CI 0.03, 2.54; p=0.263), and AVRT (RR=0.31; 0.03-3.15; p=0.319) was observed between groups. Conclusion Prophylactic CA seems effective in reducing AR in asymptomatic adult and pediatric patients with WPW pattern but does not significantly affect all-cause mortality.Graphical abstract