Skip to main content
Journal cover image

Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome: A Multicenter International Study.

Publication ,  Journal Article
Etheridge, SP; Escudero, CA; Blaufox, AD; Law, IH; Dechert-Crooks, BE; Stephenson, EA; Dubin, AM; Ceresnak, SR; Motonaga, KS; Skinner, JR ...
Published in: JACC Clin Electrophysiol
April 2018

OBJECTIVES: 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. BACKGROUND: Children with WPW syndrome are at risk of sudden death. METHODS: 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. RESULTS: 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. CONCLUSIONS: Young patients may experience LTE from WPW syndrome without prior symptoms or markers of high-risk on EPS.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JACC Clin Electrophysiol

DOI

EISSN

2405-5018

Publication Date

April 2018

Volume

4

Issue

4

Start / End Page

433 / 444

Location

United States

Related Subject Headings

  • Wolff-Parkinson-White Syndrome
  • Risk Factors
  • Retrospective Studies
  • Male
  • Humans
  • Female
  • Death, Sudden
  • Child
  • Atrial Fibrillation
  • Adolescent
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Etheridge, S. P., Escudero, C. A., Blaufox, A. D., Law, I. H., Dechert-Crooks, B. E., Stephenson, E. A., … Sanatani, S. (2018). Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome: A Multicenter International Study. JACC Clin Electrophysiol, 4(4), 433–444. https://doi.org/10.1016/j.jacep.2017.10.009
Etheridge, Susan P., Carolina A. Escudero, Andrew D. Blaufox, Ian H. Law, Brynn E. Dechert-Crooks, Elizabeth A. Stephenson, Anne M. Dubin, et al. “Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome: A Multicenter International Study.JACC Clin Electrophysiol 4, no. 4 (April 2018): 433–44. https://doi.org/10.1016/j.jacep.2017.10.009.
Etheridge SP, Escudero CA, Blaufox AD, Law IH, Dechert-Crooks BE, Stephenson EA, et al. Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome: A Multicenter International Study. JACC Clin Electrophysiol. 2018 Apr;4(4):433–44.
Etheridge, Susan P., et al. “Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome: A Multicenter International Study.JACC Clin Electrophysiol, vol. 4, no. 4, Apr. 2018, pp. 433–44. Pubmed, doi:10.1016/j.jacep.2017.10.009.
Etheridge SP, Escudero CA, Blaufox AD, Law IH, Dechert-Crooks BE, Stephenson EA, Dubin AM, Ceresnak SR, Motonaga KS, Skinner JR, Marcondes LD, Perry JC, Collins KK, Seslar SP, Cabrera M, Uzun O, Cannon BC, Aziz PF, Kubuš P, Tanel RE, Valdes SO, Sami S, Kertesz NJ, Maldonado J, Erickson C, Moore JP, Asakai H, Mill L, Abcede M, Spector ZZ, Menon S, Shwayder M, Bradley DJ, Cohen MI, Sanatani S. Life-Threatening Event Risk in Children With Wolff-Parkinson-White Syndrome: A Multicenter International Study. JACC Clin Electrophysiol. 2018 Apr;4(4):433–444.
Journal cover image

Published In

JACC Clin Electrophysiol

DOI

EISSN

2405-5018

Publication Date

April 2018

Volume

4

Issue

4

Start / End Page

433 / 444

Location

United States

Related Subject Headings

  • Wolff-Parkinson-White Syndrome
  • Risk Factors
  • Retrospective Studies
  • Male
  • Humans
  • Female
  • Death, Sudden
  • Child
  • Atrial Fibrillation
  • Adolescent