Clinical course and treatment of children and adolescents with the preexcitation syndrome − Own studies
Article Category: Original Articles/Prace Oryginalne
Published Online: Jun 30, 2018
Page range: 113 - 122
Received: Nov 14, 2017
Accepted: Mar 05, 2018
DOI: https://doi.org/10.34763/devperiodmed.20182202.113122
© 2018 Aleksandra Stasiak, Katarzyna Niewiadomska-Jarosik, Piotr Kędziora, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Introduction
Essentially, preexcitation syndrome is the presence of an accessory pathway in the heart, which can lead to serious consequences, ranging from atrioventricular reentrant tachycardia to sudden cardiac death. Wolff-Parkinson-White syndrome is the most common preexcitation syndrome.
Aim of the study
The aim of the study was to evaluate the clinical course of the disease, as well as the treatment of children and adolescents hospitalized in the Department of Pediatric Cardiology in the years 2008-2015.
Materials and methods
The study was carried out in 45 children (62 % male, 38% female; the mean age 11 years). During the study we analyzed 12-lead ECG, 24-hour Holter ECG, echocardiography and the cycloergometric exercise test. The results of treatment were also discussed.
Results
Apart from the typical features of preexcitation, the most prevalent abnormality found in ECG was atrioventricular reentrant tachycardia. In 24-hour Holter ECG the most frequently detected disorders were premature ventricular beats and premature atrial contractions. Structural heart defects were detected in 8.9% of the children. The cycloergometric exercise test was positive in 8.9% of patients. The mean duration of symptoms before the diagnosis was 2.5 years. 25% of the patients were asymptomatic. 42.2% of the children needed antiarrhythmic therapy, while 44.4% had accessory pathways ablated.
Conclusions
The most common symptom of preexcitation in the study group were heart palpitations. The most frequent type of arrhythmia in children with preexcitation syndrome was orthodromic atrioventricular reentrant tachycardia. For the majority of older children ablation of the accessory pathway was a recommended form of treatment. In younger children the standard preventive pharmacological treatment was applied for 6 to 12 months.
Charakterystyczną cechą zespołów preekscytacji jest obecność dodatkowej, nieprawidłowej drogi przewodzenia w sercu. Najczęstszym typem zespołu preekscytacji jest zespół Wolffa-Parkinsona-White’a.