Treatment of Pediatric Patients with Preexcitation Syndromes

  • D. Woodrow BensonJr.
  • Ann Dunnigan


For young patients with preexcitation syndromes the associated tachycardias and available treatment options are virtually identical to those discussed in other chapters in this book. However, the symptomatic expression of tachycardia may be quite different in young patients with preexcitation syndromes. The role of age-related changes in autonomic tone, morphologic-functional changes in the atrioventricular (AV) node or accessory connection, or changes in the initiating event of tachycardia in serially determining the presence or absence and severity of symptoms in patients with preexcitation syndromes is poorly understood. Nevertheless, age-related differences in symptom expression must be considered in treatment of the young patient. For example, unless associated heart disease is present, an otherwise healthy child may have surprisingly few symptoms from tachycardias even when the rate is rapid. Additionally, death or sudden cardiac arrest in patients with preexcitation syndromes has rarely been documented in the first decade [1–3], possibly because atrial fibrillation (the arrhythmia most closely associated with sudden death in preexcitation syndrome patients) has been reported rarely during the first decade of life [4,5]. Finally, time is often an ally, since young patients may cease having episodes of tachycardia for many years [6–8]. This phenomenon is poorly understood, and emphasizes our incomplete knowledge about the natural history of preexcitation syndromes in affected patients (see Chapter 2 by Dunnigan).


Antiarrhythmic Drug Supraventricular Tachycardia Paroxysmal Supraventricular Tachycardia Versus Connection Antiarrhythmic Drug Efficacy 
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© Martinus Nijhoff Publishing 1986

Authors and Affiliations

  • D. Woodrow BensonJr.
  • Ann Dunnigan

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