Long‐term prospective study on the natural history of Wolff‐Parkinson‐White syndrome detected during a heart screening program at school

Abstract

In the period 1985 to 1993, a total of 802 school‐aged children (284 first‐graders and 518 seventh‐graders) were referred to our hospital for further evaluation of electrocardiographic abnormalities. Among them, 57 (male 24 and female 33) children were confirmed as having Wolff‐Parkinson‐White (WPW) syndrome based on the findings of 12‐lead surface electrocardiograms (ECG). According to Lindsay's criteria, the locations of the accessory pathways were as follows: Left‐lateral in 10 (18%), left‐posterior in 2 (4%), right‐free‐wall in 28 (49%), anterior‐septum in 13 (23%) and posterior‐septum in 3 (5%). One 12‐y‐old girl had multiple accessory pathways. Six patients had associated diseases: Ebstein's anomaly in 4, epilepsy in 1 and mental retardation with scoliosis in 1. Follow‐up periods ranged from 2.0 to 13.0 y (mean SD: 8.0 ± 3.3 y) for 23 first‐graders with WPW syndrome, and from 2.0 to 13.0 y (mean SD: 7.3 ± 4.2 y) for 34 seventh‐graders, respectively. Initially, 5 children had at least one episode of supraventricular tachycardia (SVT) by history and 6 children developed SVT during the follow‐up. One girl with multiple accessory pathways and recurrent SVT required long‐term drug therapy.Conclusions: The outcome of children with WPW syndrome detected by a heart screening program at school was favorable. Our 8 y follow‐up of 57 children with WPW syndrome will serve as additional information concerning the indication of radio‐frequency catheter ablation therapy for WPW syndrome in children.