PMID: 8606283Mar 1, 1996Paper

Impact of clinical history and electrophysiologic characterization of accessory pathways on management strategies to reduce sudden death among children with Wolff-Parkinson-White syndrome

Journal of the American College of Cardiology
B I BrombergJ L Cox

Abstract

This study sought to determine whether the clinical and electrophysiologic criteria developed in adults also identify children with Wolff-Parkinson-White syndrome at risk for sudden death. In adults with Wolff-Parkinson-White syndrome, a shortest RR interval <220 ms during atrial fibrillation is a sensitive marker for sudden death. However, because reliance on the shortest RR interval has a low positive predictive value, the clinical history has assumed a pivotal role in assessing risk. This approach has not been evaluated in children. We retrospectively evaluated 60 children </= 18 years old who underwent comprehensive electrophysiologic evaluation between 1979 and 1989 before undergoing operation for Wolff-Parkinson-White syndrome. Clinical and electrophysiologic data were analyzed after patients had been grouped by their clinical presentation: high risk (cardiac arrest), intermediate risk (syncope or atrial fibrillation) or low risk (orthodromic reciprocating tachycardia alone). Ten children had a clinical cardiac arrest (high risk); only one had a prior history of syncope or atrial fibrillation. Compared with the intermediate (n = 19) and low risk groups (n = 31), there were no differences in age ([mean +/- SD] 14.8 +/- 0.6...Continue Reading

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