Journal article
Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome: A Multicenter International Study
JACC. Clinical electrophysiology, Vol.4(4), pp.433-444
04/2018
DOI: 10.1016/j.jacep.2017.10.009
PMID: 30067481
Abstract
This study sought to characterize risk in children with Wolff-Parkinson-White (WPW) syndrome by comparing those who had experienced a life-threatening event (LTE) with a control population.
Children with WPW syndrome are at risk of sudden death.
This retrospective multicenter pediatric study identified 912 subjects ≤21 years of age with WPW syndrome, using electrophysiology (EPS) studies. Case subjects had a history of LTE: sudden death, aborted sudden death, or atrial fibrillation (shortest pre-excited RR interval in atrial fibrillation [SPERRI] of ≤250 ms or with hemodynamic compromise); whereas subjects did not. We compared clinical and EPS data between cases and subjects.
Case subjects (n = 96) were older and less likely than subjects (n = 816) to have symptoms or documented tachycardia. Mean age at LTE was 14.1 ± 3.9 years of age. The LTE was the sentinel symptom in 65%, consisting of rapidly conducted pre-excited atrial fibrillation (49%), aborted sudden death (45%), and sudden death (6%). Three risk components were considered at EPS: SPERRI, accessory pathway effective refractory period (APERP), and shortest paced cycle length with pre-excitation during atrial pacing (SPPCL), and all were shorter in cases than in control subjects. In multivariate analysis, risk factors for LTE included male sex, Ebstein malformation, rapid anterograde conduction (APERP, SPERRI, or SPPCL ≤250 ms), multiple pathways, and inducible atrial fibrillation. Of case subjects, 60 of 86 (69%) had ≥2 EPS risk stratification components performed; 22 of 60 (37%) did not have EPS-determined high-risk characteristics, and 15 of 60 (25%) had neither concerning pathway characteristics nor inducible atrioventricular reciprocating tachycardia.
Young patients may experience LTE from WPW syndrome without prior symptoms or markers of high-risk on EPS.
Details
- Title: Subtitle
- Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome: A Multicenter International Study
- Creators
- Susan P Etheridge - Division of Cardiology, Department of Pediatrics, Primary Children's Hospital, University of Utah, Salt Lake City, Utah. Electronic address: susan.etheridge@hsc.utah.eduCarolina A Escudero - Division of Cardiology, Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, CanadaAndrew D Blaufox - Division of Pediatric Cardiology, Department of Pediatrics, Cohen Children's Medical Center of New York, Hofstra-Northwell School of Medicine, New Hyde Park, New YorkIan H Law - Department of Pediatrics, Division of Cardiology, Stead Family Children's Hospital, University of Iowa, Iowa City, IowaBrynn E Dechert-Crooks - Division of Cardiology, Department of Pediatrics, University of Michigan Children's Hospital, University of Michigan, Ann Arbor, MichiganElizabeth A Stephenson - Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Ontario, CanadaAnne M Dubin - Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CaliforniaScott R Ceresnak - Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CaliforniaKara S Motonaga - Division of Pediatric Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Palo Alto, CaliforniaJonathan R Skinner - Greenlane Paediatric and Congenital Cardiac Service, Starship Children's Hospital, University of Auckland, Auckland, New ZealandLuciana D Marcondes - Greenlane Paediatric and Congenital Cardiac Service, Starship Children's Hospital, University of Auckland, Auckland, New ZealandJames C Perry - Cardiology Division, Department of Pediatrics, Rady Children's Hospital, University of California San Diego, San Diego, CaliforniaKathryn K Collins - Division of Cardiology, Children's Hospital Colorado, University of Colorado, Aurora, ColoradoStephen P Seslar - Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WashingtonMichel Cabrera - Cardiocentro Pediatrico William Soler, Havana, CubaOrhan Uzun - Department of Paediatric Cardiology, University Hospital of Wales, Cardiff, Wales, United KingdomBryan C Cannon - Department of Pediatrics, Division of Pediatric Cardiology, Mayo Clinic, Rochester, MinnesotaPeter F Aziz - Division of Pediatric Cardiology, Cleveland Clinic Foundation, Cleveland, OhioPeter Kubuš - Children's Heart Centre, Charles University and Motol University Hospital, Prague, Czech RepublicRonn E Tanel - Department of Pediatrics, Benioff Children's Hospital, University of California San Francisco, San Francisco, CaliforniaSantiago O Valdes - Division of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston TexasSara Sami - Division of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston TexasNaomi J Kertesz - Nationwide Children's Hospital, Columbus, OhioJennifer Maldonado - Department of Pediatrics, Division of Cardiology, Stead Family Children's Hospital, University of Iowa, Iowa City, IowaChristopher Erickson - Division of Pediatric Cardiology in the Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NebraskaJeremy P Moore - Department of Pediatrics, Division of Pediatric Cardiology, UCLA Health System, University of California Los Angeles, Los Angeles, CaliforniaHiroko Asakai - Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Ontario, CanadaLuAnn Mill - Division of Pediatric Cardiology in the Department of Pediatrics, Children's Hospital and Medical Center, Omaha, NebraskaMark Abcede - Cardiology Division, Department of Pediatrics, Rady Children's Hospital, University of California San Diego, San Diego, CaliforniaZebulon Z Spector - Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WashingtonShaji Menon - Division of Cardiology, Department of Pediatrics, Primary Children's Hospital, University of Utah, Salt Lake City, UtahMark Shwayder - Division of Cardiology, Department of Pediatrics, Primary Children's Hospital, University of Utah, Salt Lake City, UtahDavid J Bradley - Division of Cardiology, Department of Pediatrics, University of Michigan Children's Hospital, University of Michigan, Ann Arbor, MichiganMitchell I Cohen - Phoenix Children's Hospital, University of Arizona College of Medicine, Phoenix, ArizonaShubhayan Sanatani - Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
- Resource Type
- Journal article
- Publication Details
- JACC. Clinical electrophysiology, Vol.4(4), pp.433-444
- DOI
- 10.1016/j.jacep.2017.10.009
- PMID
- 30067481
- NLM abbreviation
- JACC Clin Electrophysiol
- ISSN
- 2405-500X
- eISSN
- 2405-5018
- Language
- English
- Date published
- 04/2018
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984093213902771
Metrics
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