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- Publisher Website: 10.1007/s00246-020-02285-3
- Scopus: eid_2-s2.0-85078156262
- PMID: 31974716
- WOS: WOS:000536092600009
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Article: Non-invasive Risk Stratification in Pediatric Ventricular Pre-excitation
Title | Non-invasive Risk Stratification in Pediatric Ventricular Pre-excitation |
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Authors | |
Keywords | Pediatric Risk stratification Sudden death Ventricular pre-excitation Wolff-Parkinson-White syndrome |
Issue Date | 2020 |
Publisher | Springer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00246 |
Citation | Pediatric Cardiology, 2020, v. 41, p. 709-715 How to Cite? |
Abstract | Children with ventricular pre-excitation are at risk for sudden death. This retrospective pediatric study identified patients > 8 years of age who had undergone electrophysiology study (EPS). Our primary objective was to determine the performance characteristics of non-invasive risk stratification. Subjects were separated into two groups. Group 1 was asymptomatic or had non-specific symptoms (palpitations, chest pain, and light headedness) without documented supraventricular tachycardia (SVT). Group 2 had syncope, documented SVT, or a life-threatening event. As a secondary aim, we tested whether patients with severe symptoms had a shorter time from the date of diagnosis to the date of invasive risk stratification. Among 93 patients with an average age of 14.2 years, 25 patients had documented SVT, 6 had syncope, and 1 had a life-threatening event. The sensitivity of non-invasive risk stratification was 7%. The specificity was 91%. The positive predictive valve was 14% and the negative predictive value was 84%. Even patients with severe symptoms commonly underwent non-invasive risk stratification prior to EPS, albeit at a lower rate (Group 1, 98%; Group 2 84%, p = 0.02). The median time to EPS was 4.2 months (Group 1) and 4.5 months (Group 2, p = 0.63). Non-invasive risk stratification was a poor predictor of invasive risk stratification. Cardiologists should counsel families about the limitations of non-invasive risk stratification and consider starting with invasive risk stratification and possible ablation. Counterintuitively, severe symptoms were not associated with a shorter time to electrophysiology study. |
Persistent Identifier | http://hdl.handle.net/10722/288130 |
ISSN | 2023 Impact Factor: 1.5 2023 SCImago Journal Rankings: 0.745 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Khaznadar, R | - |
dc.contributor.author | Chandler, SF | - |
dc.contributor.author | Chaouki, AS | - |
dc.contributor.author | Tsao, S | - |
dc.contributor.author | Webster, G | - |
dc.date.accessioned | 2020-10-05T12:08:18Z | - |
dc.date.available | 2020-10-05T12:08:18Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Pediatric Cardiology, 2020, v. 41, p. 709-715 | - |
dc.identifier.issn | 0172-0643 | - |
dc.identifier.uri | http://hdl.handle.net/10722/288130 | - |
dc.description.abstract | Children with ventricular pre-excitation are at risk for sudden death. This retrospective pediatric study identified patients > 8 years of age who had undergone electrophysiology study (EPS). Our primary objective was to determine the performance characteristics of non-invasive risk stratification. Subjects were separated into two groups. Group 1 was asymptomatic or had non-specific symptoms (palpitations, chest pain, and light headedness) without documented supraventricular tachycardia (SVT). Group 2 had syncope, documented SVT, or a life-threatening event. As a secondary aim, we tested whether patients with severe symptoms had a shorter time from the date of diagnosis to the date of invasive risk stratification. Among 93 patients with an average age of 14.2 years, 25 patients had documented SVT, 6 had syncope, and 1 had a life-threatening event. The sensitivity of non-invasive risk stratification was 7%. The specificity was 91%. The positive predictive valve was 14% and the negative predictive value was 84%. Even patients with severe symptoms commonly underwent non-invasive risk stratification prior to EPS, albeit at a lower rate (Group 1, 98%; Group 2 84%, p = 0.02). The median time to EPS was 4.2 months (Group 1) and 4.5 months (Group 2, p = 0.63). Non-invasive risk stratification was a poor predictor of invasive risk stratification. Cardiologists should counsel families about the limitations of non-invasive risk stratification and consider starting with invasive risk stratification and possible ablation. Counterintuitively, severe symptoms were not associated with a shorter time to electrophysiology study. | - |
dc.language | eng | - |
dc.publisher | Springer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00246 | - |
dc.relation.ispartof | Pediatric Cardiology | - |
dc.rights | This is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: https://doi.org/[insert DOI] | - |
dc.subject | Pediatric | - |
dc.subject | Risk stratification | - |
dc.subject | Sudden death | - |
dc.subject | Ventricular pre-excitation | - |
dc.subject | Wolff-Parkinson-White syndrome | - |
dc.title | Non-invasive Risk Stratification in Pediatric Ventricular Pre-excitation | - |
dc.type | Article | - |
dc.identifier.email | Tsao, S: stsao@hku.hk | - |
dc.identifier.authority | Tsao, S=rp02530 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1007/s00246-020-02285-3 | - |
dc.identifier.pmid | 31974716 | - |
dc.identifier.pmcid | PMC7261251 | - |
dc.identifier.scopus | eid_2-s2.0-85078156262 | - |
dc.identifier.hkuros | 315517 | - |
dc.identifier.volume | 41 | - |
dc.identifier.spage | 709 | - |
dc.identifier.epage | 715 | - |
dc.identifier.isi | WOS:000536092600009 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0172-0643 | - |