{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:17:38Z","timestamp":1787030258049,"version":"build-2736575974"},"reference-count":32,"publisher":"Sociedade Brasileira de Cardiologia","issue":"4","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  A s\u00edndrome de Wolff-Parkinson-White (WPW) \u00e9 caracterizada por pr\u00e9-excita\u00e7\u00e3o ventricular, que pode levar a eventos arr\u00edtmicos graves, como taquicardia supraventricular e fibrila\u00e7\u00e3o atrial pr\u00e9-excitada. O valor diagn\u00f3stico de testes ergom\u00e9tricos n\u00e3o invasivos para detectar vias acess\u00f3rias de alto risco permanece inconsistente na literatura.  Objetivos  Avaliar a precis\u00e3o diagn\u00f3stica de testes ergom\u00e9tricos n\u00e3o invasivos em compara\u00e7\u00e3o com os estudos eletrofisiol\u00f3gicos invasivos (EEF) para identificar vias acess\u00f3rias de alto risco na s\u00edndrome de WPW.  M\u00e9todos  De acordo com as diretrizes do PRISMA-DTA, foi realizada uma busca abrangente nas bases de dados PubMed, Scopus e Web of Science. Estudos eleg\u00edveis avaliaram a sensibilidade, especificidade e raz\u00f5es de verossimilhan\u00e7a de testes ergom\u00e9tricos n\u00e3o invasivos em pacientes com WPW, utilizando EEF como padr\u00e3o de refer\u00eancia. Para a metan\u00e1lise, foi aplicado um modelo bivariado de efeitos aleat\u00f3rios.  Resultados  Seis estudos, totalizando 765 pacientes, atenderam aos crit\u00e9rios de inclus\u00e3o. A sensibilidade combinada foi de 92,7% (IC de 95%: 88,0% \u2013 94,0%), e a especificidade combinada foi de 28,1% (IC de 95%: 23% \u2013 35,1%). A raz\u00e3o de verossimilhan\u00e7a negativa (LR-) de 0,260 (IC de 95%: 0,174 \u2013 0,387) indicou que a presen\u00e7a de uma via acess\u00f3ria de alto risco \u00e9 aproximadamente quatro vezes menos prov\u00e1vel ap\u00f3s um resultado de teste negativo. A an\u00e1lise de sensibilidade, restrita a pacientes pedi\u00e1tricos, demonstrou resultados consistentes.  Conclus\u00e3o  Testes ergom\u00e9tricos n\u00e3o invasivos demonstram uma utilidade diagn\u00f3stica razo\u00e1vel para descartar vias de alto risco na s\u00edndrome de WPW. No entanto, \u00e9 necess\u00e1ria cautela ao utilizar esses testes como crit\u00e9rios independentes para estratifica\u00e7\u00e3o de risco.<\/jats:p>","DOI":"10.36660\/abc.20240663","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T10:04:04Z","timestamp":1747044244000},"source":"Crossref","is-referenced-by-count":1,"title":["Acur\u00e1cia Diagn\u00f3stica do Teste Ergom\u00e9trico para Detectar Via Acess\u00f3ria de Alto Risco em WPW: Uma Revis\u00e3o Sistem\u00e1tica e Metan\u00e1lise"],"prefix":"10.36660","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3835-6067","authenticated-orcid":false,"given":"Jos\u00e9 Nunes de","family":"Alencar","sequence":"first","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil; Universidade Federal de S\u00e3o Paulo,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Mahamad","family":"Rassi","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0345-9100","authenticated-orcid":false,"given":"Raquel Pereira","family":"Rios","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Kiszka","family":"Scheffer","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8587-875X","authenticated-orcid":false,"given":"Guilherme Dagostin de","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Instituto Dante Pazzanese de Cardiologia,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"22636","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"7","key":"ref1","doi-asserted-by":"crossref","DOI":"10.1093\/europace\/euad165","article-title":"The Wolff-Parkinson-White Pattern in Neonates: Results from a Large Population-Based Cohort Study","volume":"25","author":"P\u00e6rregaard MM","year":"2023","journal-title":"Europace"},{"issue":"3","key":"ref2","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1161\/01.CIR.87.3.866","article-title":"A Population Study of the Natural History of Wolff-Parkinson-White Syndrome in Olmsted County, Minnesota, 1953-1989","volume":"87","author":"Munger TM","year":"1993","journal-title":"Circulation"},{"issue":"7","key":"ref3","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/S0002-9149(99)80136-2","article-title":"Aborted Sudden Death in the Wolff-Parkinson-White Syndrome","volume":"76","author":"Timmermans C","year":"1995","journal-title":"Am J Cardiol"},{"issue":"10","key":"ref4","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1161\/CIRCULATIONAHA.114.011154","article-title":"Wolff-Parkinson-White Syndrome in the Era of Catheter Ablation: Insights from a Registry Study of 2169 Patients","volume":"130","author":"Pappone C","year":"2014","journal-title":"Circulation"},{"issue":"3","key":"ref5","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.jacc.2008.09.037","article-title":"The Natural History of Asymptomatic Ventricular Pre-Excitation a Long-Term Prospective Follow-Up Study of 184 Asymptomatic Children","volume":"53","author":"Santinelli V","year":"2009","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"ref6","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1161\/CIRCEP.113.000930","article-title":"Electrophysiologic Profile and Results of Invasive Risk Stratification in Asymptomatic Children and Adolescents with the Wolff-Parkinson-White Electrocardiographic Pattern","volume":"7","author":"Kubu\u0161 P","year":"2014","journal-title":"Circ Arrhythm Electrophysiol"},{"issue":"5","key":"ref7","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/eurheartj\/ehz467","article-title":"2019 ESC Guidelines for the Management of Patients with Supraventricular Tachycardia The Task Force for the Management of Patients with Supraventricular Tachycardia of the European Society of Cardiology (ESC)","volume":"41","author":"Brugada J","year":"2020","journal-title":"Eur Heart J"},{"issue":"6","key":"ref8","first-page":"634","article-title":"Wolff-Parkinson-White Syndrome. 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