TY - JOUR

T1 - The Wolff-Parkinson-White pattern in neonates

T2 - results from a large population-based cohort study

AU - Pærregaard, Maria Munk

AU - Hartmann, Joachim

AU - Sillesen, Anne-Sophie

AU - Pihl, Christian

AU - Dannesbo, Sofie

AU - Kock, Thilde Olivia

AU - Pietersen, Adrian

AU - Raja, Anna Axelsson

AU - Iversen, Kasper Karmark

AU - Bundgaard, Henning

AU - Christensen, Alex Hørby

N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2023

Y1 - 2023

N2 - AIMS: Wolff-Parkinson-White (WPW) syndrome is a conduction disorder characterized by an accessory electrical pathway between the atria and ventricles, which may predispose to supraventricular tachycardia (SVT) and sudden cardiac death. It can be seen as an isolated finding or associated with structural heart disease. Our aims were to determine the prevalence of a WPW pattern in a large and unselected cohort of neonates and to describe the electro- and echocardiographic characteristics as well as the natural history during early childhood.METHODS AND RESULTS: Electrocardiograms and echocardiograms of neonates (aged 0-30 days) from a large, prospective, population-based cohort study were included. Neonates with a WPW pattern were identified and matched 1:4 to controls. Localization of the accessory pathway was assessed by different algorithms. Among 17 489 neonates, we identified 17 (76% boys) with a WPW pattern consistent with a prevalence of 0.1%. One neonate had moderate mitral regurgitation while other echocardiographic parameters were similar between cases and controls (all P > 0.05). The accessory pathways were primarily predicted to be left-sided. At follow-up (available in 14/17 children; mean age 3.2 years) the pre-excitation pattern persisted in only four of the children and none of the children had experienced any episodes of SVT.CONCLUSION: The prevalence of a WPW pattern in our cohort of unselected neonates was 0.1%. The WPW pattern was more frequent in boys and generally not associated with structural heart disease, and the accessory pathways were primarily left-sided. At follow-up, the WPW pattern had disappeared in most of the children suggesting either an intermittent nature or that normalization occurs.CLINICAL TRIAL REGISTRATION: Copenhagen Baby Heart, NCT02753348.

AB - AIMS: Wolff-Parkinson-White (WPW) syndrome is a conduction disorder characterized by an accessory electrical pathway between the atria and ventricles, which may predispose to supraventricular tachycardia (SVT) and sudden cardiac death. It can be seen as an isolated finding or associated with structural heart disease. Our aims were to determine the prevalence of a WPW pattern in a large and unselected cohort of neonates and to describe the electro- and echocardiographic characteristics as well as the natural history during early childhood.METHODS AND RESULTS: Electrocardiograms and echocardiograms of neonates (aged 0-30 days) from a large, prospective, population-based cohort study were included. Neonates with a WPW pattern were identified and matched 1:4 to controls. Localization of the accessory pathway was assessed by different algorithms. Among 17 489 neonates, we identified 17 (76% boys) with a WPW pattern consistent with a prevalence of 0.1%. One neonate had moderate mitral regurgitation while other echocardiographic parameters were similar between cases and controls (all P > 0.05). The accessory pathways were primarily predicted to be left-sided. At follow-up (available in 14/17 children; mean age 3.2 years) the pre-excitation pattern persisted in only four of the children and none of the children had experienced any episodes of SVT.CONCLUSION: The prevalence of a WPW pattern in our cohort of unselected neonates was 0.1%. The WPW pattern was more frequent in boys and generally not associated with structural heart disease, and the accessory pathways were primarily left-sided. At follow-up, the WPW pattern had disappeared in most of the children suggesting either an intermittent nature or that normalization occurs.CLINICAL TRIAL REGISTRATION: Copenhagen Baby Heart, NCT02753348.

KW - Child

KW - Child, Preschool

KW - Female

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Male

KW - Accessory Atrioventricular Bundle

KW - Cohort Studies

KW - Electrocardiography

KW - Heart Diseases/complications

KW - Prospective Studies

KW - Tachycardia, Supraventricular/diagnosis

KW - Wolff-Parkinson-White Syndrome/diagnosis

U2 - 10.1093/europace/euad165

DO - 10.1093/europace/euad165

M3 - Journal article

C2 - 37465966

VL - 25

JO - Europace

JF - Europace

SN - 1099-5129

IS - 7

ER -