Spontaneous Resolution of Ventricular Pre-Excitation During Childhood: A Retrospective Study

Area of Science:

• Pediatric Cardiology
• Electrophysiology
• Cardiac Arrhythmias

Background:

• Ventricular pre-excitation (VP) in children carries a risk of sudden cardiac death.
• Transcatheter ablation is a potential treatment but involves risks, particularly in young children.
• Accessory pathways (APs) responsible for VP may spontaneously lose conduction over time.

Purpose of the Study:

• To determine the probability of spontaneous resolution of VP in children.
• To identify factors associated with the resolution of VP during childhood.

Main Methods:

• Retrospective study of 153 pediatric patients diagnosed with VP before age 12.
• Inclusion criteria: VP diagnosis, referral to tertiary care centers (1993-2021).
• Exclusion criteria: complex congenital heart disease; analysis using left-truncated Kaplan-Meier.

Main Results:

• Estimated anterograde conduction persistence at age 1: 53%; at age 16: 33.8%.
• Absence of symptoms and intermittent VP were linked to a higher likelihood of resolution.
• No major arrhythmic events were reported during the follow-up period.

Conclusions:

• A conservative management strategy is supported for younger children diagnosed with VP.
• A significant percentage of pediatric patients experience spontaneous VP resolution, negating the need for invasive procedures.
• Early identification and monitoring can guide treatment decisions, avoiding unnecessary interventions.