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01-06-2019 | AV Reentrant Tachycardia | Review Article

Management of Asymptomatic Wolff–Parkinson–White Pattern in Young Patients: Has Anything Changed?

Authors: Daniela Raposo, Natália António, Helena Andrade, Pedro Sousa, António Pires, Lino Gonçalves

Published in: Pediatric Cardiology | Issue 5/2019

Abstract

The approach to pediatric asymptomatic Wolff–Parkinson–White (WPW) patients is controversial. The objective of this review is to update the last consensus of specialists of the Pediatric and Congenital Electrophysiology Society/Heart Rhythm Society on this subject in order to summarize the most recent evidence on the management of young patients with asymptomatic WPW pattern. A systematic review of the literature published between 2008 and 2018 was performed taking into account the protocol of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in PubMed (including Cochrane), Embase, and Web of Science. Observational, experimental, and multicentric studies were included. Out of a total of 37 articles selected, 4 were considered eligible. Most studies considered a cutoff age of 8 or greater as recommended in the 2012 consensus. The identification of a shortest pre-excitatory RR interval (SPERRI) ≤ 250 ms seems to be the best predictor for risk stratification. The importance of routine isoprenaline use to improve the sensitivity of the electrophysiological study to identify patients at high risk of sudden death was consensual. Prophylactic ablative therapy has been indicated in asymptomatic children with an accessory pathway (AP) who have a low SPERRI and/or a low effective anterograde period of the AP and/or multiple APs. Despite the evidence found in the most recent studies, more studies are warranted in this setting.

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Title: Management of Asymptomatic Wolff–Parkinson–White Pattern in Young Patients: Has Anything Changed?
Authors: Daniela Raposo
Natália António
Helena Andrade
Pedro Sousa
António Pires
Lino Gonçalves
Publication date: 01-06-2019
Publisher: Springer US
Keywords: AV Reentrant Tachycardia
Parkinson's Disease
Published in: Pediatric Cardiology / Issue 5/2019
Print ISSN: 0172-0643
Electronic ISSN: 1432-1971
DOI: https://doi.org/10.1007/s00246-019-02110-6

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