Incidence of Life-Threatening Events in Children with Wolff-Parkinson-White Syndrome: Analysis of a Large Claims Database

Ultrasound-guided transversus abdominis plane block is an extremely attractive technique ensuring adequate perioperative analgesia. The use of ultrasound has enhanced the accuracy of local anaesthetic deposition in the plane between internal oblique and transversus abdominis, thereby blocking the spinal nerves more effectively and hence enhancing the efficacy of analgesia. Pregnancy is associated with higher frequency of arrhythmias in Wolff-Parkinson-White syndrome and poor perioperative pain management may contribute to life threatening arrhythmias. We report a case of Wolff-Parkinson-White syndrome posted for elective caesarean section, managed successfully under regional anesthesia with transverses abdominis plane block. The block and catheter were deposited under ultrasound guidance with continuous infusion of 0.2% of ropivacaine was used for postoperative pain relief. Dexmetedomidine was also used as intravenous adjunct at titrated dose of 0.4-0.6 mics/kg/min to attenuate maternal hormonal and hemodynamics during surgery.

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Wolff-Parkinson-White Syndrome

AACN Advanced Critical Care ◽

10.4037/15597768-1992-1023 ◽

1992 ◽

Vol 3 (1) ◽

pp. 180-189 ◽

Cited By ~ 1

Author(s):

Joanne Hughes Morscher

Keyword(s):

Sudden Cardiac Arrest ◽

Cardiac Conduction ◽

Treatment Modalities ◽

White Syndrome ◽

Wpw Syndrome ◽

Life Threatening ◽

History Of ◽

Diagnostic Modalities ◽

Supraventricular Tachycardias ◽

Wolff Parkinson White Syndrome

Wolff-Parkinson-White (WPW) syndrome is a cardiac conduction disorder that presents with potentially life-threatening consequences. Wolff-Parkinson-White syndrome-induced dysrhythmias account for 20% of all supraventricular tachycardias that occur in the general population. Clinical presentations range from no symptoms to a sudden cardiac arrest. The risk of sudden death is always present with WPW syndrome, and it is the motivating force in the evaluation and treatment of this syndrome. Current diagnostic modalities are accurate in identifying patients with WPW syndrome, but lack the sensitivity to predict sudden cardiac death. This article reviews the history of WPW syndrome, as well as its general characteristics, diagnostic criteria, treatment modalities, and nursing implications

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Initial forces of ventricular depolarization in the Wolff-Parkinson-White Syndrome. Analysis based upon localization of the accessory pathway by epicardial mapping.

Circulation ◽

10.1161/01.cir.52.6.1030 ◽

1975 ◽

Vol 52 (6) ◽

pp. 1030-1036 ◽

Cited By ~ 74

Author(s):

A M Tonkin ◽

G S Wagner ◽

J J Gallagher ◽

G D Cope ◽

J Kasell ◽

...

Keyword(s):

Accessory Pathway ◽

Epicardial Mapping ◽

White Syndrome ◽

Syndrome Analysis ◽

Wolff Parkinson White Syndrome ◽

Ventricular Depolarization

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Abstract 15563: Association of Weight With Ablation Outcomes in Pediatric Wolff-Parkinson-White Syndrome: Analysis of the NCDR® IMPACT Registry

Circulation ◽

10.1161/circ.142.suppl_3.15563 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Christopher M Janson ◽

Maully J Shah ◽

kevin kennedy ◽

Ramesh Iyer ◽

Shashank P Behere ◽

...

Keyword(s):

Regression Models ◽

Accessory Pathway ◽

Permanent Pacemaker ◽

White Syndrome ◽

Logistic Regression Models ◽

Ablation Success ◽

First Time ◽

Major Adverse Events ◽

Syndrome Analysis ◽

Wolff Parkinson White Syndrome

Introduction: Guidelines for electrophysiology study (EPS) and catheter ablation in Wolff-Parkinson-White syndrome (WPW) are based on age. Size is an established factor in ablation risk and may be the more appropriate factor to consider when deciding timing of EPS. Hypothesis: Weight <30 kg is associated with higher rates of major adverse events (MAE) and deferred ablation, and lower rates of success. Methods: A multicenter retrospective cohort study was performed on children age 1-21 years with WPW and first-time EPS data in IMPACT from 4/16-12/19, excluding those with congenital heart disease, cardiomyopathy, and > 1 ablation target. MAE were defined as cardiac arrest, stroke, tamponade, permanent pacemaker, or unplanned cardiac / vascular surgery. Ablation success was evaluated in those with attempts. Multivariable logistic regression models were used to adjust for measurable confounders - accessory pathway (AP) type, AP location, and use of cryoablation (cryo). Results: 4456 subjects from 84 centers were evaluated, with 14% <30 kg. Subjects <30 kg were more likely to have pre-operative SVT (45% vs. 29%, p<0.001) and inducible SVT (71% vs. 61%, p<0.001), more likely to have left non-septal APs (46% vs. 37%, p<0.001), and less likely to have right septal APs (25% vs. 33%, p<0.001, Table). No difference was seen in the likelihood of deferred ablation based on weight (9.5% vs. 12%, p=0.07). Ablation success was higher in <30 kg: 95% vs. 92% (p=0.009). This effect persisted after adjusting for measurable covariates (OR 1.7, 95% CI 1.03-2.7, p = 0.04). Left non-septal AP location was also associated with success (OR 2.9, CI 1.9-4.2, p <0.0001), and cryo was negatively associated (OR 0.4, CI 0.3-0.5, p<0.0001). MAE were rare, though with higher incidence in <30 kg (0.3% vs. 0.05%, p=0.04). Conclusions: In this analysis of WPW patients with ablation data in IMPACT, weight <30 kg was associated with increased ablation success; a higher incidence of MAE (which were rare) was observed.

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Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome

JACC: Clinical Electrophysiology ◽

10.1016/j.jacep.2017.10.009 ◽

2018 ◽

Vol 4 (4) ◽

pp. 433-444 ◽

Cited By ~ 32

Author(s):

Susan P. Etheridge ◽

Carolina A. Escudero ◽

Andrew D. Blaufox ◽

Ian H. Law ◽

Brynn E. Dechert-Crooks ◽

...

Keyword(s):

White Syndrome ◽

Event Risk ◽

Life Threatening ◽

Life Threatening Event ◽

Wolff Parkinson White Syndrome

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G007 Actual data of patients with Wolff-Parkinson-White syndrome and with spontaneous life-threatening arrhythmia

Archives of Cardiovascular Diseases ◽

10.1016/s1875-2136(09)72282-x ◽

2009 ◽

Vol 102 ◽

pp. S64

Author(s):

C. Tatar ◽

B. Brembilla-Perrot

Keyword(s):

Actual Data ◽

White Syndrome ◽

Life Threatening ◽

Wolff Parkinson White Syndrome

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Anesthetic Management of a Patient with Wolff-Parkinson-White Syndrome for Laparoscopic Cholecystectomy: A Case Report

Journal of Nepal Medical Association ◽

10.31729/jnma.5217 ◽

2020 ◽

Vol 58 (229) ◽

Author(s):

Kiran Kumar KC ◽

Sundar Hyoju ◽

Pawan Kumar Raya

Keyword(s):

Laparoscopic Cholecystectomy ◽

Case Report ◽

Incidental Finding ◽

Anesthetic Management ◽

Accessory Pathway ◽

Exertional Dyspnea ◽

White Syndrome ◽

Balanced Anesthesia ◽

Life Threatening ◽

Wolff Parkinson White Syndrome

Wolff-Parkinson-White syndrome, an electrophysiological disorder of heart caused by preexcitation of an abnormal accessory pathway,can either be asymptomatic or may present with palpitation or exertional dyspnea. We report a case of an asymptomatic 45-year-old male with incidental finding of Wolff-Parkinson-White syndrome posted for laparoscopic cholecystectomy under general anesthesia. The anesthetic management of these patients is challenging as they are prone to develop life-threatening tachyarrhythmia. Taking all the necessary precautions to prevent tachyarrhythmia, balanced anesthesia, rigorous monitoring and preparedness with necessary drugs and equipment to treat any complications is the cornerstone for positiveoutcome.

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Probable Association of Tachyarrhythmia With Nebulized Albuterol in a Child With Previously Subclinical Wolff Parkinson White Syndrome

The Journal of Pediatric Pharmacology and Therapeutics ◽

10.5863/1551-6776-17.1.93 ◽

2012 ◽

Vol 17 (1) ◽

pp. 93-97

Author(s):

Michiel Kroesen ◽

Machiel Maseland ◽

Jaime Smal ◽

Annet Reimer ◽

Petra van Setten

Keyword(s):

Adverse Effect ◽

Pediatric Patients ◽

Probability Scale ◽

White Syndrome ◽

Wpw Syndrome ◽

First Case ◽

Life Threatening ◽

Reentry Tachycardia ◽

Wolff Parkinson White Syndrome ◽

Arrhythmogenic Effects

We present the case of a 2-year-old asthmatic boy with atrioventricular (AV)-reentry tachycardia following albuterol inhalation, who was later diagnosed with Wolff-Parkinson-White (WPW) syndrome. The Naranjo adverse drug reaction probability scale score for this adverse event was 7, indicating that the association between his AV-reentry tachycardia and inhalation of albuterol is probable. To our knowledge, this is the first case report that shows the potential arrhythmogenic effects of albuterol in a child with WPW syndrome. We urge clinicians to be aware of this potentially life-threatening adverse effect and to closely monitor these patients when they need beta-adrenergic drugs in case of emergency. Furthermore, this report highlights the dilemma regarding the safe treatment of pediatric patients with both asthma and WPW syndrome.

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Anesthetic management “Abdominal Aortic Aneurysm” in the well-known case with Wolff-Parkinson-White syndrome

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1338 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Sogol Asgari ◽

◽

Arash Tafrishinejed ◽

Faranak Behnaz ◽

◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Anesthetic Management ◽

Careful Monitoring ◽

White Syndrome ◽

Abdominal Aortic ◽

Balanced Anesthesia ◽

Life Threatening ◽

History Of ◽

Wolff Parkinson White Syndrome

Wolff-Parkinson-White syndrome is an electrophysiological disorder of the heart caused by pre-stimulation of an abnormal lateral pathway that can be asymptomatic or may be accompanied by palpitations or shortness of breath. We reported a case of a 66-yearold man with a history of Wolff-Parkinson syndrome who was transferred to the operating room for simultaneous nephrectomy due to RCC and abdominal aortic aneurysm. Managing the anesthesia of these patients is challenging because they are prone to life-threatening tachyarrhythmias. Observance of all necessary precautions to prevent tachyarrhythmias, balanced anesthesia, careful monitoring and preparation with the necessary drugs and equipment to treat any complication, is the cornerstone of a positive surgical outcome. Keywords: Wolff Parkinson white syndrome; abdominal aortic aneurysm; electrophysiological disorder; anesthetic management.

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Cardiac diseases of young people. I: Longterm management of Wolff-Parkinson-White syndrome

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-80-70 ◽

1994 ◽

Vol 80 (2) ◽

pp. 70-75

Author(s):

A Fitchet ◽

M L Cowley

Keyword(s):

Prognostic Factors ◽

Radiofrequency Ablation ◽

Careful Consideration ◽

Cardiac Diseases ◽

White Syndrome ◽

Bypass Tract ◽

Life Threatening ◽

Term Management ◽

Wolff Parkinson White Syndrome

AbstractWhen symptoms occur in the presence of ventricular pre-excitation careful consideration should be given to the patient’s long term management. Bypass tract radiofrequency ablation may be offered as a potential cure for patients with intractable symptoms or in those at high risk of life threatening arrhythmias. In certain cases, ablation may be justified even when symptoms are minor and there are no adverse prognostic factors. Options for treatment are discussed and illustrated by two cases.

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