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A longitudinal study on electrophysiological properties of atrioventricular accessory pathways in infants and
S Ding1, N Sumitomo, H Ushinohama
1Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan.
Insights
Accessory pathway (AP) electrophysiological properties change during childhood development. These changes can lead to altered conduction and reduced pre-excitation in pediatric patients with supraventricular tachycardia.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Accessory pathways (APs) are congenital cardiac anomalies that can cause supraventricular tachycardia.
- Electrophysiological properties of APs may change with age, but data in infants and children is limited.
Purpose of the Study:
- To investigate the developmental electrophysiological changes in accessory pathway properties in infants and children.
- To assess the impact of these changes on tachycardia induction and conduction properties.
Main Methods:
- Intracardiac and/or transesophageal electrophysiological studies were performed on two groups: infants (mean age 2 months) and children (mean age 9 years).
- Studies were conducted at baseline (study 1) and follow-up (study 2) to document changes in AP properties and tachycardia induction.
- Orthodromic atrioventricular tachycardia was documented in all participants at study 1.
Main Results:
- Supraventricular tachycardia was inducible in 43% of infants and 100% of children at follow-up.
- Developmental changes in AP antegrade conduction properties were observed.
- Loss or intermittent pre-excitation was documented in a subset of patients, indicating altered AP function over time.
Conclusions:
- Accessory pathway electrophysiological properties undergo significant developmental changes throughout childhood.
- These changes can influence the inducibility of supraventricular tachycardia and the manifestation of pre-excitation.
- Understanding these developmental trends is crucial for managing pediatric patients with accessory pathways.
Abstract:
In this study the electrophysiological developmental changes of accessory pathway (AP) properties in infants and children are examined. Intracardiac and/or transesophageal electrophysiological studies were performed on seven infants (group 1, mean age 2 months) and four children (group 2, mean age 9 y; study 1), and documented orthodromic atrioventricular tachycardia in all cases. At follow-up study (study 2), supraventricular tachycardia was induced in three of seven (43%) cases in group 1 and in all four cases in group 2. Changes in antegrade conduction properties of AP were documented by loss of pre-excitation (two of four cases in group 1) or change to intermittent pre-excitation (one of two cases in group 2).