Transesophageal and invasive electrophysiologic evaluation in children with Wolff‐Parkinson‐White pattern

Abstract

Holter and EST have low predictive value in WPW risk stratification. However, TEEPS and EPS are extremely valuable in WPW risk stratification. TEEPS may reveal important and useful results for WPW risk determination, especially in small children not having undergone EPS in order to avoid its complications.

Heart rate variability parameters in children with ventricular preexcitation

“…Today, the management of the pediatric patients with ventricular preexcitation includes the identification of the risk of sudden cardiac death. Ablation is preferred for pediatric patients whose accessory pathway conduction is found to be at risk and those with inducible tachycardia . In this study, it was hypothesized that the autonomic nervous system may affect the behavior of the accessory pathway and the clinical characteristics of ventricular preexcitation patients.…”

“…Ablation is preferred for pediatric patients whose accessory pathway conduction is found to be at risk and those with inducible tachycardia. 17,18 In this study, it was hypothesized that the autonomic nervous system may affect the behavior of the accessory pathway and the clinical characteristics of ventricular preexcitation patients. We assessed HRV parameters in healthy controls and ventricular preexcitation pediatric patients, whose risk stratification was performed with TEEPS.…”

“…concluded that there were no significant differences between the baseline APERP found in TEEPS versus EPS . TEEPS is a safe and feasible procedure that can be used in the assessment of the risk of ventricular preexcitation, with a similar efficacy to EPS . The risk markers used for this purpose have been focused on the determination of the conduction properties of the accessory pathway.…”

“…16 TEEPS is a safe and feasible procedure that can be used in the assessment of the risk of ventricular preexcitation, with a similar efficacy to EPS. 16,17 The risk markers used for this purpose have been focused on the determination of the conduction properties of the accessory pathway. The autonomic nervous system, which has a widespread impact on the heart, is expected to affect accessory pathway features in ventricular preexcitation.…”

Electroanatomic mapping guided pediatric catheter ablation with limited/zero fluoroscopy

“…In patients with Wolff Parkinson White pattern (WPW); the conduction properties of accessory pathway (AP), were assessed. The antegrade conduction of the manifest AP measured during EPS was classified as risky conduction if any of the following three conditions were met: 1:1 conduction through AP to a paced cycle length of ≤250 ms using incremental or burst atrial pacing; an AP-effective refractory period of ≤250 ms on a single atrial extrastimulus protocol; or shortest pre-excited RR interval during atrial fibrillation of ≤250 ms ( 8 ). Ablation procedures were performed in patients scheduled for ventricular premature beat (VPB) ablation on outpatient evaluation, those with high-risk WPW patients, and those with inducible tachycardia.…”