The exact prevalence of ventricular pre-excitation is difficult to estimate because most patients are asymptomatic. Intermittent pre-excitation and loss of pre-excitation over time also add to the challenge. The prevalence of WPW-pattern ECG in the general population is 0.1% to 0.3%. The yearly incidence is 0.004% to 0.1% (50% of these are asymptomatic). The male-to-female ratio is 2:1. Signs of pre-excitation were absent in the initial ECG in 22% of subjects with WPW-pattern ECG and 40% of these lost pre-excitation on subsequent ECG recordings. The prevalence of WPW syndrome varies with the population studied. In a review of 22,500 healthy aviation personnel, the WPW pattern was seen in 0.25%; however, only 1.8% of these patients had documented arrhythmias. It can be encountered at any age, but the highest incidence is in the third and fourth decades of life. In a report of 228 subjects with WPW syndrome, the overall incidence of arrhythmia was 1% per year during a 22-year follow-up.
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