Abstract
PO-01-011 CLINICAL AND ELECTROPHYSIOLOGICAL CHARACTERISTICS OF PEDIATRIC WOLFF-PARKINSON-WHITE: INSIGHTS FROM A MULTICENTER AMBISPECTIVE REGISTRY
Heart rhythm, Vol.22(4 Supplement), pp.S128-S129
04/2025
DOI: 10.1016/j.hrthm.2025.03.277
Abstract
Background
Wolff-Parkinson-White (WPW) exhibits variable presentations and outcomes in pediatric populations. Understanding clinical and EP characteristics is critical for optimizing risk stratification and management.
Objective
Evaluate differences in presentation, clinical course, and EP study (EPS) findings in pediatric WPW patients (pts), focusing on life-threatening events (LTEs) and the impact of age on outcomes.
Methods
A multicenter international ambispective registry from 2017—2024 of WPW pts <21 years was used. High-risk accessory pathways (HR-APs) were defined as AP effective refractory period (APERP), shortest preexcited R-R interval (SPERRI) during atrial fibrillation (AF), or shortest preexcited paced cycle length (SPPCL) ≤250 ms. Outcomes included clinical presentation and course, EPS findings, and LTEs (sudden death [SD], aborted SD, or clinical preexcited AF with SPERRI ≤250ms or hemodynamic instability).
Results
Of 1302 pts enrolled (mean presenting age 10.3 ±6.1 years, 56% male), CHD was present in 7.5%, and 23% had non-persistent preexcitation (PE). Younger age was associated with increased ED visits, hospitalizations and antiarrhythmic use (p <0.001). Among pts who underwent EPS (1066, 83%), HR-APs were more common in younger pts (p <0.001).
LTEs occurred in 22 pts (1.7%) and were the sentinel symptom in 60% of cases. LTE data are summarized in the Table. A higher proportion of LTE pts had HR-APs and multiple APs compared to non-LTE pts (p <0.001 for both). No differences in sex, age group, CHD, or non-persistent PE were observed between LTE and non-LTE pts.
Conclusion
The clinical course of WPW varies by age, with younger pts requiring more healthcare resources. Though rare, LTEs often arise during routine activities, are associated with HR-APs and multiple APs, and occur despite nonpersistent PE. These findings underscore the importance of proactive risk assessment and management in all pediatric WPW pts, regardless of PE persistence.
Details
- Title: Subtitle
- PO-01-011 CLINICAL AND ELECTROPHYSIOLOGICAL CHARACTERISTICS OF PEDIATRIC WOLFF-PARKINSON-WHITE: INSIGHTS FROM A MULTICENTER AMBISPECTIVE REGISTRY
- Creators
- Mary C. NiuBrynn E. Dechert-CrooksCheyenne BeachIqbal El-AssaadReina B. TanCharles C. AndersonChristopher C. EricksonNicholas H. Von BergenLindsey E. Malloy-WaltonNaomi J. KerteszPeter F. AzizGaurav AroraChristopher M. JansonIan H. LawAhmad S. ChaoukiAndrew D. BlaufoxElizabeth A. StephensonRonn E. TanelPrince J. KannankerilDavid GamboaJayaprakash ShentharShubhayan SanataniSusan P. EtheridgeCarolina A. Escudero
- Resource Type
- Abstract
- Publication Details
- Heart rhythm, Vol.22(4 Supplement), pp.S128-S129
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.hrthm.2025.03.277
- ISSN
- 1547-5271
- Language
- English
- Date published
- 04/2025
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984815916902771
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