Response to Letter Regarding Article, “Wolff-Parkinson-White Syndrome in the Era of Catheter Ablation: Insights From a Registry Study of 2169 Patients”

We thank Fenici et al for their interest in our experience on the natural history of the Wolff-Parkinson-White (WPW) syndrome.1 The authors, on the basis of their experience, suggest the routine use of ambulatory transesophageal atrial pacing (TEAP) as an intermediate approach to minimize “invasiveness” for risk assessment in the asymptomatic WPW population. It is well known that, unlike invasive electrophysiological testing (EPT), TEAP provides less accurate information about “the real electrophysiological profile of the risk” in WPW patients. Potential limitations are an approximate value of the anterograde refractory period of accessory pathways (APs), no identification of multiple APs, no reproducibility or inducibility of atrial fibrillation, no information on AP …