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Prevalence of ventricular preexcitation in Japanese schoolchildren
1Second Department of Internal Medicine, Yamanashi Medical University, Japan.
Insights
The prevalence of ventricular preexcitation and accessory pathways increases with age in schoolchildren. This study found fewer symptoms and no significant morbidity associated with Wolff-Parkinson-White syndrome in this population.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Public Health
Background:
- Wolff-Parkinson-White syndrome (WPW) is a congenital condition with unknown prevalence due to intermittent accessory pathway activity.
- Autonomic tone fluctuations can also impact WPW presentation.
Purpose of the Study:
- To determine the prevalence of ventricular preexcitation and associated symptoms in schoolchildren.
- Investigate age-related differences in preexcitation prevalence.
Main Methods:
- A comprehensive survey of 92,161 schoolchildren in Yamanashi prefecture (ages 6-15) was conducted.
- Data collection included questionnaires, physical examinations, and electrocardiography from 1994-1996.
Main Results:
- Prevalence of preexcitation was significantly higher in high school students (0.174%) compared to elementary (0.073%) and junior high (0.070%) students.
- Left free wall pathways were most common in older students.
- Palpitations were the only reported symptom, with no significant increase in symptomatic cases with age.
Conclusions:
- Preexcitation prevalence in younger children is lower than previously thought.
- Preexcitation and left free wall pathways show an age-dependent increase.
- WPW syndrome in schoolchildren presents with minimal symptoms and low morbidity.
Background:
Wolff-Parkinson-White syndrome is thought to be a congenital disease, however, its exact prevalence is not known. This may be because of the intermittent activity of accessory pathways in some cases and fluctuations in autonomic tone.
Aims:
To investigate the prevalence of ventricular preexcitation by electrocardiography and reported symptoms in each school age child in Yamanashi prefecture.
Methods:
From 1994 to 1996, answers to a questionnaire, results of physical examination, and electrocardiography were obtained from all schoolchildren in Yamanashi prefecture (n = 92,161; total population 880,000) on admission to elementary school (age 6 to 7 years, n = 28,395), junior high school (age 12 to 13 years, n = 31,206), and high school (age 14 to 15 years, n = 32,837).
Results:
Elementary and junior high school students had a significantly lower prevalence of preexcitation than high school students (0.073% and 0.070% v 0.174%, p < 0.001). The prevalence of left free wall pathway was highest in high school students (n = 27) compared with elementary (n = 6) and junior high school students (n = 5) (p < 0.005). The only symptom noted in the answers to the questionnaire was palpitations. The symptomatic cases were more frequent in high school (n = 13) than in elementary (n = 1) and junior high school (n = 2) children, but not significantly. No student with preexcitation had associated heart disease or family history of Wolff-Parkinson-White syndrome or sudden death.
Conclusions:
The prevalence of preexcitation in younger schoolchildren was less frequent than previously reported. The prevalence of preexcitation and left free wall pathways increased with age. The symptoms were few and there was no significant morbidity.