Wolf-Parkinson-White Syndrome and Asymptomatic Pre-excitation in Africa (a Multicenter WPW African Registry)

A specifically designed electronic report is used and includes the patient's baseline characteristics, symptoms if present, presence of underlying heart disease, family history of any similar conditions, or sudden cardiac death (SCD). ECG analysis will be done for criteria of WPW pattern, localization of the site of the accessory pathway, and the algorithm used for that; all will be recorded. Our sample is divided according to clinical presentation into patients with WPW syndrome (those with symptoms or documented tachycardia) and asymptomatic subjects (ventricular pre-excitation on ECG without symptoms). In patients with WPW syndrome, data will be collected, including symptoms, type of documented tachyarrhythmia, acute management of this arrhythmia on time, and the long-term management strategy, either pharmacological or interventional therapy. In patients who are referred for electrophysiological (EP) study for mapping and radiofrequency (RF) catheter ablation, all data are recorded, including the method of the study, either fluoroscopic guided or three-dimensional (3D mapping), acute success, site of successful ablation, complications, and long-term success after a one-year follow-up. Regarding asymptomatic subjects, we collect data on risk stratification, either a noninvasive assessment like a stress electrocardiogram or an invasive electrophysiological (EP) study, and allowance to do exercise and practice sports. At the end of the study, the performance of each center regarding the management strategy for WPW syndrome was assessed blindly by two European heart rhythm association (EHRA) certified experts in electrophysiology field based on the recent published guidelines of European society of cardiology (ESC). Socio-economic determinants and health metrics such as the human development index (HDI), health expenditure as a percentage of the gross demographic product (GDP), and the effective health coverage index (UHC) will be compiled together with the EP procedure density of each center to determine the impact of health governance in the management of patients with cardiac pre-excitation. EP procedure density is defined as the ratio between the number of procedures and the years of experience of the index center.