Journal of Pediatric Cardiology and Cardiac Surgery

Background: Studies have indicated varying prevalence rates of Wolff–Parkinson–White (WPW) syndrome in young people, with various ages at initial episode of tachycardia. We aimed to investigate the incidence of subsequent tachycardia in asymptomatic schoolchildren who are first diagnosed as having WPW syndrome via secondary screening at our hospital.

Methods: From April 2011 to December 2023, 82 patients with suspected WPW syndrome based on school-based electrocardiograms (ECGs) underwent the second cardiac screening at our department. Of these, 62 patients (37 male patients) were diagnosed with WPW syndrome. Whether tachycardia occurred or not, age at onset if occurred, and ECG features were analyzed.

Results: Tachycardia occurred in 11 (18%) of the 62 patients, not significantly differing between sexes. Age at onset of tachycardia ranged from 10 to 16 years old, with the highest frequency observed at 12 years old (36%). Tachycardia was most frequently observed in patients with type A WPW syndrome (positive delta wave in lead V1); whereas the type of WPW syndrome did not differ between the tachycardia and the non-tachycardia groups. Additionally, no tachycardic episodes were observed in the 11 patients with intermittent WPW syndrome. The delta-wave amplitude seemed higher in the tachycardia group versus the non-tachycardia group, but this result was not statistically significant.

Conclusion: In the clinical follow-up of asymptomatic patients with WPW syndrome, when tachycardia attacks tend to occur should be taken into account to avoid delay in appropriate therapeutic intervention.