Interest of non-invasive and semi-invasive testings in asymptomatic children with pre-excitation syndrome.
OBJECTIVE
To determine the feasibility and the results of exercise testing (ET) and electrophysiological study (EPS) in outpatient asymptomatic children with a Wolff-Parkinson-White (WPW) syndrome.


RESULTS
Exercise testing and transesophageal EPS were performed in 55 outpatient asymptomatic children aged 6 to 19 years old (14 +/- 3) with WPW. Wolff-Parkinson-White persisted during maximal exercise. Isoproterenol was not required in five children younger than 10 years old, because they developed a catecholaminergic sinus tachycardia. Maximal rate conducted through accessory pathway (AP) was higher in children younger than 16 years old than in teenagers (P < 0.05). Atrioventricular re-entrant tachycardia (AVRT) was induced in six children; atrial fibrillation (AF) in 12 children. The induction of tachycardias and the dangerous forms (18%) were not influenced by age. After 5 +/- 1 years, one child, 12 year old with inducible rapid AF, had a sudden cardiac arrest; two children became symptomatic after ablation.


CONCLUSIONS
Transesophageal EPS was required to determine the prognosis of asymptomatic WPW in children. The maximal rate conducted in AP was higher in children younger than 16 years old than in teenagers; other data did not differ. AVRT was rare; 71% of children had no inducible arrhythmia and were authorized to resume physical activities.
Brembilla-Perrot
B
B
Cardiology, CHU of Brabois, Rue du Morvan 54511, 54500, Vandoeuvre, France. b.brembilla-perrot@chu-nancy.fr
Chometon
F
F
Groben
L
L
Ammar
S
S
Bertrand
J
J
Marcha
C
C
Cloez
J L
JL
Tisserand
A
A
Huttin
O
O
Tatar
C
C
Duhoux
F
F
Yangni N'da
O
O
Beurrier
D
D
Terrier de Chaise
A
A
Zhang
N
N
Abbas
M
M
Cedano
J
J
Marçon
F
F
D000293:Adolescent; D000328:Adult; D001281:Atrial Fibrillation; D002309:Cardiology / Q000379:methods*; D002648:Child; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D022062:Electrophysiologic Techniques, Cardiac; D004594:Electrophysiology / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007545:Isoproterenol / Q000494:pharmacology; D008297:Male; D011226:Pre-Excitation Syndromes / Q000175:diagnosis / Q000503:physiopathology*; D011379:Prognosis; D018570:Risk Assessment; D016896:Treatment Outcome; D014927:Wolff-Parkinson-White Syndrome / Q000175:diagnosis / Q000503:physiopathology
D007545:Isoproterenol