Loss of Delta Waves on Exercise in an Asymptomatic Male with Wolff-Parkinson-White Syndrome

245 Abstract During a routine examination, healthy, asymptomatic patients may present with conditions such as tachycardia. Appropriate diagnosis of WolffParkinson-White (WPW) syndrome, is important in determining risk for future arrhythmias or other complications. A 25-year-old, physically active, asymptomatic, African American male was detected with WPW during a pre-employment medical examination. His history was noncontributory. His electrocardiograph showed delta waves and short PR interval with occasional ventricular ectopies. Echocardiography showed normal valves, ventricular size and function. His exercise testing (Bruce Protocol) showed normal blood pressure response. Delta waves disappeared during exercise and reappeared during recovery. No arrhythmias were noted. However, the inability to induce an arrhythmia during electrophysiological testing does not guarantee lack of arrhythmia inducibility. Exercise test has high negative predictive value possibly eliminating the need for invasive electrophysiological testing. Delta waves disappearing during the exercise testing placed our patient at low risk; no further testing was advised. He remained asymptomatic on follow-up.