日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Children with a Wolff–Parkinson–White electrocardiography pattern are usually asymptomatic. In these patients, the initial evaluations of organic cardiac disease and differentiation from fasciculoventricular pathways are important. If atrioventricular accessory pathways exist, the patient can develop atrioventricular reentrant tachycardia, rarely preexcited atrial fibrillation with rapid ventricular responses, sudden cardiac death, and heart failure caused by ventricular dyssynchrony. Risk stratification of fatal arrhythmic events by using noninvasive tests is thought to be difficult. The incidence of complications after catheter ablation is higher in smaller children. The acute effect, recurrence, and complication rates of catheter ablation are related to the location of the accessory pathway. Management is determined by the balance between the potential cardiovascular risks of accessory pathways and the possible complications of electrophysiological study and catheter ablation.