Difficulties with invasive risk stratification performed under anesthesia in pediatric Wolff-Parkinson-White Syndrome

Shwayder, Mark; Escudero, Carolina A.; Etheridge, Susan P.; Dechert, Brynn E.; Law, Ian H.; Blaufox, Andrew D.; Perry, James C.; Dubin, Anne M.; Sanatani, Shubhayan; Collins, Kathryn K.

doi:10.1016/j.hrthm.2019.09.011

Cited by 12 publications

(9 citation statements)

References 18 publications

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“…8 However, given that significant arrhythmias and aborted sudden death have been reported in patients who do not demonstrate high-risk EPS features, and taking into account that SPERRI, shortest paced cycle length with preexcitation, and APERP recorded in the electrophysiology lab setting may not correlate well with the SPERRI recorded during a clinically recorded arrhythmia, ablation of an AP should be considered based on the anatomic location. 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

Wolff-Parkinson-White pattern in the setting of antibody-mediated rejection after heart transplant

Chong

Waqar

Elkhouly

et al. 2023

HeartRhythm Case Reports

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Section: Discussionmentioning

confidence: 99%

Wolff-Parkinson-White pattern in the setting of antibody-mediated rejection after heart transplant

Chong

Waqar

Elkhouly

et al. 2023

HeartRhythm Case Reports

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“…A 12‐lead EKG evaluation should be performed for patients with preexisting WPWS and for anticipated extensive procedures 72 . The so‐called gold standard for the prediction of sudden death with WPWS is the shortest pre‐excited RR interval 73 . Identification of this electrophysiological finding is deemed essential for presurgical risk stratification.…”

Section: Discussionmentioning

confidence: 99%

“…72 The so-called gold standard for the prediction of sudden death with WPWS is the shortest pre-excited RR interval. 73 Identification of this electrophysiological finding is deemed essential for presurgical risk stratification. Appropriate anaesthetic selections are important to reduce the risk of arrhythmia formation and sympathetic excitation.…”

Section: Preoperative Considerations With Wpwsmentioning

confidence: 99%

Wolff–Parkinson–White syndrome: Review of published cases associated with head and neck/oral and maxillofacial procedures

et al. 2022

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Aim The objective of this article is to review the demographics, diagnostic criteria, etiopathogenesis, comorbidities and management of Wolff–Parkinson–White syndrome (WPWS). In addition, the relevant cardiovascular outcomes of published cases involving head and neck/oral and maxillofacial procedures were summarized. Materials and Methods A search of the PubMed database, restricted to human studies published in the English language literature, was performed from 1960 through July 2021 for articles. Results The search strategy yielded 24 patients, totalling 25 dates of treatment, with WPWS concordant with head and neck/oral and maxillofacial procedures, predominately involving biopsy, tumour resection and extractions; significantly, 5 of whom, experienced their first episode of WPWS while undergoing treatment of the head and neck. None of the procedures resulted in patient death. Conclusions Practitioners should be familiar with the clinical features of WPWS and be prepared to manage emergent cardiovascular deterioration. Electrocardiogram monitoring of this cohort is advised during head and neck/oral and maxillofacial surgical procedures, particularly involving general anaesthesia. Breakthrough episodes of WPWS may still occur in patients who have previously undergone cardioconversion.

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“…The effect of most anaesthetic drugs on conduction speed and the refractory period has been studied, principally derived from anaesthetic management during EPS. [4][5][6] Anaesthetic agents proven to be devoid of effect on cardiac conduction are fentanyl, remifentanil, alfentanil, propofol, etomidate, cis-atracurium, and rocuronium. 7 In fact, propofol has been shown to normalize WPW conduction in one case series.…”

Section: Discussionmentioning

confidence: 99%

Wolff-Parkinson-White syndrome: anaesthetic care for meningioma excision

Leong

Miskan

Sivanaser

2022

MYJA

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In Wolff-Parkinson-White (WPW) syndrome, the presence of an accessory pathway between the atrium and ventricle predisposes the patient to paroxysmal supraventricular tachyarrhythmias, which may progress to ventricular fibrillation and sudden cardiac death. Several drugs that are used perioperatively may alter the cardiac conduction velocity and refractory period. This fact, interacting with factors such as increased sympathetic tone (e.g., anxiety, pain, or seizure) or haemorrhage, leads to tachycardia, where shortened R-R interval predisposes the heart to re-entrant tachyarrhythmias. We reported and highlighted the perioperative issues while anaesthetising a 15-year-old boy with WPW syndrome for craniotomy and excision of parietal meningioma.

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Difficulties with invasive risk stratification performed under anesthesia in pediatric Wolff-Parkinson-White Syndrome

Cited by 12 publications

References 18 publications

Wolff-Parkinson-White pattern in the setting of antibody-mediated rejection after heart transplant

Wolff-Parkinson-White pattern in the setting of antibody-mediated rejection after heart transplant

Wolff–Parkinson–White syndrome: Review of published cases associated with head and neck/oral and maxillofacial procedures

Wolff-Parkinson-White syndrome: anaesthetic care for meningioma excision

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