Wolf-Parkinson-White pattern in children: features of examination and observation
E.V. PSHENICHNAYA, N.A. TONKIKH, N.A. USENKO, V.V. SOSNA
Donetsk National Medical University named after M. Gorkiy, Donetsk, Ukraine
Contact details:
Pshenichnaya E.V. – PhD (medicine), Associate Professor, Head of the Department of Pediatrics
Address: 16a prospekt Ilyicha, 283003 Donetsk, Ukraine, tel.: +3(8099)-492-55-54, e-mail: pshenichnayal@yandex.ru
Objective. To present a review of the literature and a clinical example of the Wolf-Parkinson-White phenomenon in a child involved in sports.
Methods. A clinical example of the Wolf-Parkinson-White phenomenon in a child is described. A lesion of heart conductivity was initially found by cardiologist examination where the patient applied to solve the question whether he could continue doing sports. The results of a complex examination are presented: standard ECG, daily monitoring ECG, load test, intra-esophageal electrophysiology study.
Results. According to standard ECG and Holter monitoring ECG, we found alteration of of sinus rhythm with normal atrioventricular conductivity and QRS complexes of the WPW type, with a frequency of 1: 1. Under the load we registered mainly sinus rhythm with normal atrioventricular conductivity and under restitution – preexcitation syndrome. During non-invasive electrophysiology study, the paroxysm of supraventricular tachycardia was not induced. Effective refractrory period of additional atrioventricular connection was 320 ms.
Conclusions. The obtained data enabled to estimate the risk of atrial fibrillation and sudden death as low. The child was recommended low-static physical load with low and middle dynamic component. Children with Wolf-Parkinson-White syndrome engaged in sports are recommended to undergo complex examination to determine the degree of risk of emergency states and optimal training regime.
Key words: WPW pattern, sport, children.
(For citation: Pshenichnaya E.V., Tonkikh N.A., Usenko N.A., Sosna V.V. Wolf-Parkinson-White pattern in children: features of examination and observation. Practical Medicine. 2019, Vol. 17, № 5, P. 38-42)
REFERENCES
- Page R.L., Joglar J.A., Caldwell M.A. et al. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary. Journal of the American College of Cardiology, 2016, vol. 67 (13), pp. 1575-623.
- Diagnostika i lechenie narusheniy ritma i provodimosti serdtsa u detey: Uchebnoe posobie, pod redaktsiey M.A. Shkol’nikovoy, D.F. Egorova [Diagnosis and treatment of cardiac arrhythmias and conduction in children: textbook. Ed. by M.A. Shkolnikova, D.F. Egorov]. Saint Petersburg: Chelovek, 2012. 432 p.
- Rekomendatsii vserossiyskogo nauchnogo obshchestva spetsialistov po klinicheskoy elektrofiziologii, aritmologii i kardiostimulyatsii (VNOA) [Recommendations of the All-Russian Scientific Society of Specialists in Clinical Electrophysiology, Arrhythmology and Cardiac Stimulation (VNOA)]. Moscow, 2013. 596 p.
- Lu C.W., Wu M.H., Chen H.C. et al. Epidemiological profile of Wolff-Parkinson-White syndrome in a general population younger than 50 years of age in an era of radiofrequency catheter ablation. Int. J. Cardiol, 2014, vol. 174, pp. 530-534.
- Sharma S., Drezner J.A., Baggish A. et al. International recommendations for electrocardiographic interpretation in athletes. European Heart Journal, 2018, vol. 39 (16), pp. 1466-1480, https://doi.org/10.1093/eurheartj/ehw631
- Cain N., Irving C., Webber S. et al. Natural history of Wolff-Parkinson-White syndrome diagnosed in childhood. Am. J. Cardiol, 2013, vol. 112 (7), pp. 961-965. doi: 10.1016/j.amjcard.2013.05.035
- Pappone C., Vicedomini G., Manguso F. et al. Wolff-Parkinson-white syndrome in the era of catheter ablation: insights from a registry study of 2169 patients. Circulation, 2014, vol. 130, pp. 811-819.
- Etheridge S.P., Escudero C.A., Blaufox A.D. et al. Life-threatening event risk in children with Wolff-Parkinson-White syndrome: a multicenter international study. JACC Clin. Electrophysiol, 2018, vol. 4 (4), pp. 433-444. doi: 10.1016/j.jacep.2017.10.009.
- Al-Khatib S.M., Arshad A., Balk E.M. et al. Risk Stratification for Arrhythmic Events in Patients With Asymptomatic Pre-Excitation: A Systematic Review for the 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J. Am. Coll. Cardiol, 2016, vol. 67 (13), pp. 1624-1638. doi: 10.1016/j.jacc.2015.09.018.
- Pshenichnaya E.V., Parshin S.A., Tonkikh N.A. Improving the effectiveness of the diagnosis of WPW syndrome in children. Vestnik neotlozhnoy i vosstanovitel’noy khirurgii, 2016, vol. 1, no.1, pp. 115-118 (in Russ.).
- National recommendations on the admission of athletes with deviations from the cardiovascular system to the training and competitive process. Ratsional’naya farmakoterapiya v kardiologii, 2011, no. 7 (6), pp. 1-59 (in Russ.).
- Muresan L., Cismaru G., Martins R.P. et al. Recommendations for the use of Electrophysiological Study: Update 2018. Hellenic Journal of Cardiology, 2018. doi: https://doi.org/10.1016/j.hjc.2018.09.002.