PROGNOSTIC FACTORS OF WOLFF-PARKINSON-WHITE SYNDROME IN CHILDREN

2021 ◽  
Vol 5 (1) ◽  
pp. 1128-1136
Author(s):  
E. Zasim ◽  
◽  
V. Strogiy ◽  
Keyword(s):  
Prognostic Factors ◽  
Family History ◽  
Sinus Node ◽  
Left Ventricular ◽  
Sinus Node Dysfunction ◽  
White Syndrome ◽  
Wpw Syndrome ◽  
Paroxysmal Tachycardia ◽  
History Of ◽  
Wolff Parkinson White Syndrome

Objective: to determine the prognostic factors determining the severity of Wolff-Parkinson-White syndrome (WPW) in children. Methods: a retrospective analysis of the course of the disease was performed in 108 children with WPW syndrome aged 13.6 (12-16) years. Depending on the number of attacks of paroxysmal tachycardia (PT), all children were divided into 2 groups: group A consisted of 47 children (43.5%) with a history of no more than three attacks of PT and they were rare; group B included 61 children (56.5%) with frequent (more than once a month) attacks of PT, more than four in the history. We studied: the family history, the clinical picture of the disease, the nature of paroxysmal tachycardia, the effectiveness of treatment, and the results of instrumental studies. Using the method of mathematical modeling, the informative value of each feature was determined, and the diagnostic value was determined. Results: age and gender differences in the development of WPW syndrome in children were established. The presence of a family history of ECG signs of ventricular preexcitation is a reliable sign (p=0.02), contributing to more frequent PT attacks. More frequent development of PT attacks was noted in patients with mitral valve prolapse (p=0.03) and additional chords in the left ventricular cavity (p=0.001). In the group with frequent PT attacks, signs of sinus node dysfunction were detected more often (<0.001). According to the echocardiographic study, children with frequent PT attacks were more likely to have disorders in the form of thickening of the interventricular septum in the diastole (p=0.010) and signs of diastolic dysfunction of the right ventricle (p = 0.010). Conclusion: The factors of prognostic value include: male gender, the presence of the expressed symptoms of the attack of PT and PT frequency more than once per month, low vagal efficiency on relieving the attack, a history of frequent attacks, a family history of ECG characteristics of premature ventricular excitation, the presence of signs of sinus node dysfunction during 24 hours without the attack and the signs of arrhythmogenic myocardial dysfunction by echocardiography.

Wolff-Parkinson-White Syndrome

1992 ◽  
Vol 3 (1) ◽  
pp. 180-189 ◽  
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

scholarly journals Effective catheter ablation in a case of Wolff-Parkinson-White syndrome with sinus node dysfunction.

1997 ◽  
Vol 17 (1) ◽  
pp. 70-77
Author(s):  
Masakazu Aruga ◽  
Yuuichi Katagiri ◽  
Yasuyuki Sasaki ◽  
Kazuhiro Suyama ◽  
Ryuuichi Sakai ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
White Syndrome ◽  
Wolff Parkinson White Syndrome

WOLFF-PARKINSON-WHITE SYNDROME WITH CONGENITAL HEART DISEASE

PEDIATRICS ◽  
1949 ◽  
Vol 4 (2) ◽  
pp. 210-213
Author(s):  
ESTELLE E. KLEIBER
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Conduction System ◽  
First Episode ◽  
White Syndrome ◽  
Paroxysmal Tachycardia ◽  
History Of ◽  
Wolff Parkinson White Syndrome ◽  
In Infants And Children

The syndrome of the shortened P-R interval associated with widened QRS as an anomaly of the conduction system of the heart has long been recognized in the adult. Since few cases of Wolff-Parkinson-White syndrome have been reported in children in association with congenital heart disease, a case report is presented in a boy whose first episode of paroxysmal tachycardia occurred at seven months of age. The diagnosis of congenital heart disease seems likely in view of the finding of a pronounced, widely heard systolic murmur first noted at the age of 2½ years, and never associated with rheumatism or other signs of infection. A history of paroxysmal tachycardia in infants and children warrants cardiographic investigation between attacks.

One Case of Cerebral Embolism Associated with Paroxysmal Tachycardia in Wolff-Parkinson-White Syndrome

1972 ◽  
Vol 2 (2) ◽  
pp. 69
Author(s):  
Rin Chang ◽  
Sung Ki Paeck ◽  
Ha Lee ◽  
Young Woo Lee ◽  
Sung Ho Lee
Keyword(s):  
Cerebral Embolism ◽  
White Syndrome ◽  
Paroxysmal Tachycardia ◽  
Wolff Parkinson White Syndrome

Sevoflurane Has No Effect on Sinoatrial Node Function or on Normal Atrioventricular and Accessory Pathway Conduction in Wolff-Parkinson-White Syndrome during Alfentanil/Midazolam Anesthesia 

1999 ◽  
Vol 90 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Michael D. Sharpe ◽  
Daniel J. Cuillerier ◽  
John K. Lee ◽  
Magdi Basta ◽  
Andrew D. Krahn ◽  
...  
Keyword(s):  
Cycle Length ◽  
Sinoatrial Node ◽  
Sinus Node ◽  
Accessory Pathway ◽  
Atrioventricular Node ◽  
Conduction Time ◽  
White Syndrome ◽  
The Right ◽  
Ablative Procedures ◽  
Wolff Parkinson White Syndrome

Background The effects of sevoflurane on the electrophysiologic properties of the human heart are unknown. This study evaluated the effects of sevoflurane on the electrophysiologic properties of the normal atrioventricular conduction system, and on the accessory pathways in patients with Wolff-Parkinson-White syndrome, to determine its suitability as an anesthetic agent for patients undergoing ablative procedures. Methods Fifteen patients with Wolff-Parkinson-White syndrome undergoing elective radiofrequency catheter ablation were studied. Anesthesia was induced with alfentanil (20-50 microg/kg) and midazolam (0.15 mg/kg), and vecuronium (20 mg) and maintained with alfentanil (0.5 to 2 microg x kg(-1) x min(-1)) and midazolam (1 or 2 mg every 10-15 min, as required). An electrophysiologic study measured the effective refractory period of the right atrium, atrioventricular node, and accessory pathway; the shortest conducted cycle length of the atrioventricular node and accessory pathway during atrial pacing; the effective refractory period of the right ventricle and accessory pathway; and the shortest retrograde conducted cycle length of the accessory pathway during ventricular pacing. Parameters of sinoatrial node function included sinus node recovery time, corrected sinus node recovery time, and sinoatrial conduction time. Intraatrial conduction time and the atrial-His interval were also measured. Characteristics of induced reciprocating tachycardia, including cycle length, atrial-His, His-ventricular, and ventriculoatrial intervals, also were measured. Sevoflurane was administered to achieve an end-tidal concentration of 2% (1 minimum alveolar concentration), and the study measurements were repeated. Results Sevoflurane had no effect on the electrophysiologic parameters of conduction in the normal atrioventricular conduction system or accessory pathway, or during reciprocating tachycardia. However, sevoflurane caused a statistically significant reduction in the sinoatrial conduction time and atrial-His interval but these changes were not clinically important. All accessory pathways were successfully identified and ablated. Conclusions Sevoflurane had no effect on the electrophysiologic nature of the normal atrioventricular or accessory pathway and no clinically important effect on sinoatrial node activity. It is therefore a suitable anesthetic agent for patients undergoing ablative procedures.

Pharmacologic therapy with flecainide for asymptomatic Wolff–Parkinson–White syndrome in an infant with severe left ventricular dyssynchrony

2018 ◽  
Vol 28 (7) ◽  
pp. 970-973
Author(s):  
Sayo Suzuki ◽  
Tatsunori Hokosaki ◽  
Mari Iwamoto
Keyword(s):  
Complete Response ◽  
Left Ventricular ◽  
Left Ventricular Dyssynchrony ◽  
Pharmacologic Therapy ◽  
White Syndrome ◽  
Ventricular Dyssynchrony ◽  
Asymptomatic Patients ◽  
Resynchronisation Therapy ◽  
Wolff Parkinson White Syndrome

AbstractSome asymptomatic patients with Wolff–Parkinson–White syndrome have severe left ventricular dyssynchrony and dysfunction. We describe a patient who was given a diagnosis of Wolff–Parkinson–White syndrome in infancy and had a complete response to pharmacologic therapy with flecainide. Our findings suggest that flecainide is a suitable resynchronisation therapy for such infants.

P1259Right atrial low voltage zone as a novel predictor of sinus node dysfunction in patients with non-paroxysmal atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Kondo ◽  
M Kimura ◽  
M Nakayama ◽  
O Matsuda
Keyword(s):  
Atrial Fibrillation ◽  
Low Voltage ◽  
Sinus Node ◽  
Pacemaker Implantation ◽  
Left Ventricular ◽  
Sinus Node Dysfunction ◽  
Right Atrial ◽  
Left Ventricular Ejection ◽  
Ablation Procedure ◽  
Ventricular Ejection Fraction

Abstract Background Although sinus node dysfunction (SND) coexists with atrial fibrillation (AF) in some cases, SND in patients with Non-paroxysmal AF (Non-PAF) could not be estimated in conventional electrophysiological study. Atrial low voltage zone (LVZ), which may be surrogate for atrial fibrosis, is although reported to present in patients with Non-PAF, the association between SND and right atrial LVZ (RA-LVZ) has not been fully evaluated. The aim of the present study was to assess the relationship between SND and RA-LVZ in patients with Non-PAF. Method Eighty-six Non-PAF patients underwent high density voltage mapping of right atrium (RA) during AF before ablation procedure. We defined LVZ as that with electrogram amplitude <0.1 mV in order to delineate strongly damaged area in RA. We evaluated the surface are of the RA-LVZ in Non-PAF patients with and without SND. Results Twenty-seven of 86 patients (31.4%) presented with SND after AF termination. There were no significant differences between patients with and without SND in variables such as age, sex, AF duration, left atrial diameter, and left ventricular ejection fraction. The mean value of RA-LVZ of all the patients was 12.1±11.4%, and RA-LVZ was significantly larger in patients with SND than in those without SND (22.8±14.6 vs 7.2±4.2%; P<0.001). In multivariate logistic regression analysis for the incidence of subsequent pacemaker implantation (PMI), only RA-LVZ was a significant predictor of subsequent PMI (odd ratio 1.306; 95% confidence interval 1.159 - 1.473; P<0.001). Receiving-operating characteristic curve for PMI following ablation procedure indicated cut-off value 10.5% for RA-LVZ with 85.2% sensitivity and 88.1% specificity (area under curve = 0.924, P<0.001). Kaplan-Meier analysis of the incidence of PMI after AF termination showed that freedom from pacemaker implantation was significantly better in patients with RA-LVA <10.5% than in those with RA-LVZ ≥10.5% (log-rank test; P<0.001). Conclusions Broad RA-LVZ measured during AF was strongly associated with SND and PMI after AF termination in patients with Non-PAF. Evaluation of RA-LVZ during AF could be a potential target in predicting SND requiring PMI in patients with Non-PAF.

scholarly journals A case of wide complex tachycardia in wolff-parkinson-white syndrome

2019 ◽  
Vol 6 (4) ◽  
pp. 1
Author(s):  
Jonathan Lowenthal ◽  
Jack Xu ◽  
Eric Pagan ◽  
Richard Tangel ◽  
Daniel Schaer ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Accessory Pathway ◽  
White Syndrome ◽  
Presenting Symptoms ◽  
Wide Complex Tachycardia ◽  
Pr Interval ◽  
History Of ◽  
Ventricular Preexcitation ◽  
Posteroseptal Accessory Pathway ◽  
Wolff Parkinson White Syndrome

The manifestation of atrial flutter, particularly with 1:1 conduction, is rare in patients with ventricular preexcitation secondary to Wolff-Parkinson-White Syndrome (WPW). Very few cases have been reported in the literature. We present a 40-year old male with a history of untreated WPW who presented with severe chest pain and shortness of breath. He was found to have a rapid, regular, wide complex tachycardia. He underwent successful synchronized cardioversion, in which the patient converted tonormal sinus rhythm with classic WPW waveform characteristics, including a shortened PR interval and prolonged QRS complex with a slurred upstroke. Surprisingly, a subsequent electrophysiology study revealed atrial flutter, with bystander conduction of 1:1 atrial flutter being the most likely cause of the patient’s presenting symptoms, and a posteroseptal accessory pathway consistent with the diagnosis of WPW. While considerably rarer than ventricular tachycardia or AVRT, it is nevertheless important for clinicians to consider atrial flutter with 1:1 conduction as a potential diagnosis in patients with WPW presenting with wide complex tachycardia.

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