Follow-up of 134 Pediatric Patients with Wolff-Parkinson-White Pattern:Natural Outcome and Medical Treatment

ObjectiveThe aim of the study was to evaluate the outcome of a pediatric population with ventricular pre-excitation pattern, supraventricular tachycardia, atrial fibrillation, cardiomyopathies, mortality and medical treatment. MethodsFrom 1976 to 2011, a descriptive observational study was conducted on patients with ventricular pre-excitation in the electrocardiogram.All patients underwent an echocardiogram, 101(75.3%)Holter monitoring, and 69 (51.5%) an ergometric test.Radiofrequency ablation was performed in selected patients.Data were expressed as mean and standard deviation. ResultsThe study population consisted of 134 patients; 80 (59.7%) were male.Age at diagnosis ranged from 2 days to 18 years (mean 6.5±5 years).Clinical follow-up lasted 1 month to 20 years (mean 3.6±3.9years).Thirty five patients (26.1%) consulted for supraventricular tachycardia, 16 (11.9%)for ventricular pre-excitation, and the remaining 83 patients (61.9%) for other abnormalities.Seventy-six patients (56.7%) had left conduction pathway and 3 patients double conduction pathway.Sixteen patients (11.9%) presented supraventricular tachycardia during follow-up.Overall, 51 patients (38%) had orthodromic tachycardia at 6.3±5.8 years, 10 patients during the neonatal period.Thirty-eight patients (28.3%) received antiarrhythmic drugs.No atrial fibrillation was observed.Twenty-eight patients (20.9%) presented cardiomyopathy, 9 with supraventricular tachycardia.No association was found between supraventricular tachycardia and another variable.Forty-three patients (32.1%) underwent radiofrequency ablation.A patient suffered sudden death and another patient died during the postoperative period of cardiomyopathy surgery. Conclusions1.More than 60% of patients remained asymptomatic.2) No atrial fibrillation was recorded.3) Sudden death rate was 0.75%.4) Patients with supraventricular tachycardia not submitted to ablation had a favorable outcome.5) Supraventricular tachycardia was not associated with any variable.6) Multiple conduction pathways always developed supraventricular tachycardia.