Analysis of clinical and electrophysiological characteristics of children with Wolff-Parkinson-White syndrome or ventricular pre-excitation
10.3760/cma.j.issn.2095-428X.2019.17.015
- VernacularTitle: 儿童预激综合征/心室预激临床及电生理特性分析
- Author:
Baojing GUO
1
;
Chencheng DAI
;
Qiangqiang LI
;
Zhiyuan WANG
Author Information
1. Department of Pediatric Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing 100029, China
- Publication Type:Journal Article
- Keywords:
Wolff-Parkinson-White syndrome;
Electrophysiology;
Atrioventricular reentrant tachycardia;
Anterograde refractory period of accessory pathways
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(17):1344-1347
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical and electrophysiological characteristics of children with Wolff-Parkinson-White syndrome or ventricular pre-excitation.
Methods:One hundred and seventy-nine consecutive children with Wolff-Parkinson-White syndrome or ventricular pre-excitation who were hospitalized at Beijing Anzhen Hospital Affiliated to Capital Medical University and planned to accept radiofrequency ablations were selected.Electrocardiogram and echocardiography were completed and detailed clinical data were collected before ablations.Anterograde refractory period of accessory pathways (ERPAPA) and retrograde ventriculoatrial conduction were measured during electrophysiology studies.The clinical and electrophysiological characteristics of these children were analyzed.
Results:The ratio of left-sided to right-sided accessory pathways was 1.001.93(61 cases vs.118 cases). Six out of 61 patients with left-sided accessory pathways were verified by electrophysiology study.There was no statistical difference of P-R interval and QRS duration between patients with right-sided and left-sided accessory pathways(all P>0.05). Twelve patients were combined with congenital heart diseases.Fourteen patients with right-sided accessory pathways were of ventricular pre-excitation induced dilated cardiomyopathy.ERPAPA was measured successfully in 110 patients, ERPAPA less than 250 ms accounted for 32.7%(36/110 cases). Six children with two pathways were recognized.Antidromic atrioventricular reentrant tachycardia was induced in 3 children.One child had slow conduction pathway localized in right-sided septum.
Conclusions:Right-sided overt accessory pathways are more common in children with Wolff-Parkinson-White syndrome or ventricular pre-excitation.Organic heart diseases are not uncommon.Besides congenital heart disease, a small proportion of patients with right overt accessory pathways may develop ventricular pre-excitatory induced dilated cardiomyopathy resulting from ventricular wall dyskinesia.Most of the decremental retrograde ventriculoatrial conduction is the characteristic of ventricular muscles rather than the accessory pathways in nature.Two pathways are not uncommon in children with Wolff-Parkinson-White syndrome or ventricular pre-excitation.Before finishing radiofrequency ablation, the anterograde and retrograde function of the accessory pathway should be evaluated in detail again because it is easy to neglect the existence of another accessory pathway.
