Clinical and electrophysiologic characteristics of antidromic tachycardia in children with Wolff-Parkinson-White syndrome

Scott R. Ceresnak, Ronn E. Tanel, Robert H. Pass, Leonardo Liberman, Kathryn K. Collins, George F. Van Hare, Gregory J. Gates, Anne M. Dubin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Antidromic reciprocating tachycardia (ART) is a rare form of wide complex tachycardia in children with Wolff-Parkinson-White syndrome (WPW). The incidence and electrophysiologic characteristics of ART in children with WPW have not been well described. Methods: A multicenter retrospective analysis of all patients with WPW undergoing electrophysiology (EP) study from 1990 to 2009 was performed. Patients with clinical or inducible ART were included. Results: A total of 1,147 patients with WPW underwent EP study and 30 patients had ART (2.6%) and were the subject of this analysis. The mean age was 16 ± 3 years, weight was 65 ± 16 kg, and tachycardia cycle length was 305 ± 55 ms. There were two patients (7%) with congenital heart disease (both with Ebstein's anomaly). Four patients (13%) had more than one accessory pathway (AP). The location of the AP was left sided in 53% of patients and right sided in 47%, with septal location and left lateral pathways most commonly involved. AP conduction was found to be high risk in 17 patients (57%). Ablation was not attempted in two patients (7%) due to proximity to the HIS and risk of heart block. Ablation was acutely successful in 93% of the patients in whom it was attempted. Conclusions: ART is a rare finding in children undergoing EP study. Over half of the patients with ART were found to be high risk and multiple AP were uncommon. Unlike the adult population, ART occurred commonly with septal APs.

Original languageEnglish (US)
Pages (from-to)480-488
Number of pages9
JournalPACE - Pacing and Clinical Electrophysiology
Volume35
Issue number4
DOIs
StatePublished - Apr 2012

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Wolff-Parkinson-White Syndrome
Reciprocating Tachycardia
Tachycardia
Electrophysiology
Ebstein Anomaly
Heart Block
Patient Rights
Heart Diseases
Weights and Measures

Keywords

  • accessory pathway
  • antidromic reciprocating tachycardia
  • electrophysiology testing
  • pediatrics
  • Wolff-Parkinson White syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical and electrophysiologic characteristics of antidromic tachycardia in children with Wolff-Parkinson-White syndrome. / Ceresnak, Scott R.; Tanel, Ronn E.; Pass, Robert H.; Liberman, Leonardo; Collins, Kathryn K.; Van Hare, George F.; Gates, Gregory J.; Dubin, Anne M.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 35, No. 4, 04.2012, p. 480-488.

Research output: Contribution to journalArticle

Ceresnak, Scott R. ; Tanel, Ronn E. ; Pass, Robert H. ; Liberman, Leonardo ; Collins, Kathryn K. ; Van Hare, George F. ; Gates, Gregory J. ; Dubin, Anne M. / Clinical and electrophysiologic characteristics of antidromic tachycardia in children with Wolff-Parkinson-White syndrome. In: PACE - Pacing and Clinical Electrophysiology. 2012 ; Vol. 35, No. 4. pp. 480-488.
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AU - Tanel, Ronn E.

AU - Pass, Robert H.

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AU - Collins, Kathryn K.

AU - Van Hare, George F.

AU - Gates, Gregory J.

AU - Dubin, Anne M.

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N2 - Background: Antidromic reciprocating tachycardia (ART) is a rare form of wide complex tachycardia in children with Wolff-Parkinson-White syndrome (WPW). The incidence and electrophysiologic characteristics of ART in children with WPW have not been well described. Methods: A multicenter retrospective analysis of all patients with WPW undergoing electrophysiology (EP) study from 1990 to 2009 was performed. Patients with clinical or inducible ART were included. Results: A total of 1,147 patients with WPW underwent EP study and 30 patients had ART (2.6%) and were the subject of this analysis. The mean age was 16 ± 3 years, weight was 65 ± 16 kg, and tachycardia cycle length was 305 ± 55 ms. There were two patients (7%) with congenital heart disease (both with Ebstein's anomaly). Four patients (13%) had more than one accessory pathway (AP). The location of the AP was left sided in 53% of patients and right sided in 47%, with septal location and left lateral pathways most commonly involved. AP conduction was found to be high risk in 17 patients (57%). Ablation was not attempted in two patients (7%) due to proximity to the HIS and risk of heart block. Ablation was acutely successful in 93% of the patients in whom it was attempted. Conclusions: ART is a rare finding in children undergoing EP study. Over half of the patients with ART were found to be high risk and multiple AP were uncommon. Unlike the adult population, ART occurred commonly with septal APs.

AB - Background: Antidromic reciprocating tachycardia (ART) is a rare form of wide complex tachycardia in children with Wolff-Parkinson-White syndrome (WPW). The incidence and electrophysiologic characteristics of ART in children with WPW have not been well described. Methods: A multicenter retrospective analysis of all patients with WPW undergoing electrophysiology (EP) study from 1990 to 2009 was performed. Patients with clinical or inducible ART were included. Results: A total of 1,147 patients with WPW underwent EP study and 30 patients had ART (2.6%) and were the subject of this analysis. The mean age was 16 ± 3 years, weight was 65 ± 16 kg, and tachycardia cycle length was 305 ± 55 ms. There were two patients (7%) with congenital heart disease (both with Ebstein's anomaly). Four patients (13%) had more than one accessory pathway (AP). The location of the AP was left sided in 53% of patients and right sided in 47%, with septal location and left lateral pathways most commonly involved. AP conduction was found to be high risk in 17 patients (57%). Ablation was not attempted in two patients (7%) due to proximity to the HIS and risk of heart block. Ablation was acutely successful in 93% of the patients in whom it was attempted. Conclusions: ART is a rare finding in children undergoing EP study. Over half of the patients with ART were found to be high risk and multiple AP were uncommon. Unlike the adult population, ART occurred commonly with septal APs.

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