Radiofrequency Ablation in Children with Asymptomatic Wolff–Parkinson–White Syndrome

Pappone, Carlo; Manguso, Francesco; Santinelli, R; Vicedomini, Gabriele; Sala, Simone; Paglino, Gabriele; Mazzone, Patrizio; Lang, Christopher; Gulletta, Simone; Augello, Giuseppe; Santinelli, Ornella; Santinelli, Vincenzo

doi:10.1056/nejmoa040625

Cited by 191 publications

(107 citation statements)

References 22 publications

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“…Multiple APs have been shown to be a risk factor for VF [17]. In addition to conferring increased risk, these patients are also more likely to be symptomatic [18].…”

Section: Ecg and Ambulatory Monitoringmentioning

confidence: 99%

“…The authors concluded that prophylactic ablation in high-risk children with WPW reduces the chance of a life-threatening arrhythmia. However, the authors initially randomized 60 patients and subsequently 10 patients withdrew from the ablation group of the study, which may have affected the conclusions of the study [17]. Sarrubi et al studied 57 asymptomatic children with WPW, 48 % of whom had sustained SVT on initial EPS and received medical treatment or ablation.…”

Section: Invasive Evaluation Of Asymptomatic Wpwmentioning

confidence: 99%

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Evaluation and Management of the Asymptomatic Child with Wolff–Parkinson–White

et al. 2016

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Wolff-Parkinson-White (WPW) describes an accessory pathway (AP) that connects the atria and ventricles and allows preexcitation of the ventricle, manifested on the electrocardiogram (ECG) as a short PR interval and a delta wave. WPW syndrome describes the abnormal ECG pattern in patients with associated clinical cardiovascular symptoms, whereas ''isolated ventricular preexcitation,'' ''asymptomatic WPW,'' or ''asymptomatic WPW syndrome'' all refer to the abnormal ECG pattern without associated clinical cardiovascular symptoms. The clinical presentation of symptomatic WPW in young patients with structurally normal hearts can vary based on age and accessory pathway properties. Unfortunately, sudden cardiac death (SCD) can be the first manifestation in patients with WPW. Non-invasive modalities (ECG, ambulatory monitoring, and exercise testing) are used to risk stratify patients. A more invasive test (electrophysiology study) can then be used to identify high-risk pathways. Finally, radiofrequency and/or cryoablation are used to eliminate the accessory pathway and eliminate the risk of arrhythmia and SCD.

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“…Multiple APs have been shown to be a risk factor for VF [17]. In addition to conferring increased risk, these patients are also more likely to be symptomatic [18].…”

Section: Ecg and Ambulatory Monitoringmentioning

confidence: 99%

Section: Invasive Evaluation Of Asymptomatic Wpwmentioning

confidence: 99%

Evaluation and Management of the Asymptomatic Child with Wolff–Parkinson–White

et al. 2016

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“…Most life-threatening arrhythmia, both in adults and the pediatric population, is aborted. 41,49 In addition, up to 31% of adults may lose the ventricular preexcitation and anterograde conduction over a 5-year period. 34 …”

Section: Age Of Presentationmentioning

confidence: 99%

Electrophysiology Testing and Catheter Ablation Are Helpful When Evaluating Asymptomatic Patients with Wolff-Parkinson-White Pattern

Skanes

Obeyesekere

Klein

2015

Cardiac Electrophysiology Clinics

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“…Patients who survived cardiac arrest tend to be symptomatic and have short cycle (RR) intervals (<250 ms) during atrial fibrillation. The clinical course of asymptomatic children with WPW syndrome has recently been investigated [75]. The authors investigated 165 children (5-12 years) in which prophylactic radiofrequency catheter ablation of accessory pathways was compared with no ablation in asymptomatic children who were at high risk for arrhythmias (i.e., reproducible …”

Section: Wolff-parkinson-white Syndromementioning

confidence: 99%

Cardiac arrhythmias and sudden death in infancy: implication for the medicolegal investigation

et al. 2006

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Genetically transmitted diseases are an important cause of juvenile sudden cardiac death (SCD). In a considerable proportion of individuals in which a medicolegal investigation is performed, structural heart disease is absent, and the medical examiner fails to discover an adequate cause of death. In such cases, an inherited arrhythmogenic disease should be considered, which manifests with life-threatening ventricular tachycardia or SCD. Molecular diagnosis is progressively becoming an important tool for these questions. Therefore, postmortem genetic testing ("molecular autopsy") should be considered as a part of the comprehensive medicolegal investigation in SCD cases without apparent structural heart disease. It will have implications not only for the deceased individual but also for living family members in preventing (further) cardiac events by expert counseling, appropriate lifestyle adjustment, and adequate treatment, if available.

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Radiofrequency Ablation in Children with Asymptomatic Wolff–Parkinson–White Syndrome

Abstract: In asymptomatic, high-risk children with the Wolff-Parkinson-White syndrome, prophylactic catheter ablation performed by an experienced operator reduces the risk of life-threatening arrhythmias.

Cited by 191 publications

References 22 publications

Evaluation and Management of the Asymptomatic Child with Wolff–Parkinson–White

Evaluation and Management of the Asymptomatic Child with Wolff–Parkinson–White

Electrophysiology Testing and Catheter Ablation Are Helpful When Evaluating Asymptomatic Patients with Wolff-Parkinson-White Pattern

Cardiac arrhythmias and sudden death in infancy: implication for the medicolegal investigation

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