Pagis B, Villain E, Hidden-Lucet F, Frank R, Sidi D
Service de cardiologie pédiatrique, hôpital Necker Enfants-Malades, AP-HP, 149, rue de Sèvres, 75743 Paris, France.
Arch Pediatr. 2003 Jan;10(1):38-41. doi: 10.1016/s0929-693x(03)00220-3.
In children, Wolff-Parkinson-White (WPW) syndrome is often revealed by reentrant tachycardia episodes. Rarely, this syndrome can be the cause of syncope or of sudden death, resulting from rapid conduction of atrial fibrillation to the ventricles through the accessory pathway.
The authors report the case of a child, who had a WPW syndrome diagnosed after birth because of a supraventricular tachycardia and who was later asymptomatic. At ten years of age, he was admitted because of palpitations due to atrial fibrillation and rapid conduction through the accessory pathway.
In a child with WPW syndrome, tachycardia with wide and irregular QRS complexes should evoke the involvement of atrial fibrillation, with rapid conduction to the ventricle. Drugs blocking conduction through the atrio-ventricular node are contra-indicated and the condition is an indication for radiofrequency ablation.
在儿童中,预激综合征(WPW)常因折返性心动过速发作而被发现。该综合征极少会因房颤通过旁路快速传导至心室而导致晕厥或猝死。
作者报告了一名儿童病例,该患儿出生后因室上性心动过速被诊断为WPW综合征,之后并无症状。10岁时,因房颤伴通过旁路的快速传导引起心悸而入院。
对于患有WPW综合征的儿童,QRS波宽大且不规则的心动过速应考虑房颤伴快速传导至心室。禁用阻断房室结传导的药物,这种情况适合进行射频消融。