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33rd International Congress on Electrocardiology

International Society of Electrocardiology

Radiofrequency catheter ablation with multiple accessory pathways in pediatric patients with Wolff-Parkinson-White syndrome

Meeting Abstract

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  • R. Gariopov - Research Institute of Pediatry, Moscow, Russland
  • corresponding author presenting/speaker S. Termosesov - Research Institute of Pediatry, Moscow, Russland
  • I. Illich - Research Institute of Pediatry, Moscow, Russland

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice026

The electronic version of this article is the complete one and can be found online at:

Published: February 8, 2007

© 2007 Gariopov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



The aim of this study is to evaluate the clinico-electrophysiology characteristics of multiple accessory pathways in children. Records were reviewed of 129 children with WPW syndrome who underwent full clinical and electrophysiology study, and radiofrequency catheter ablation at our institution. There were allotted 15 pts (10 boys and 5 girls) who had multiple accessory pathways with different electrophysiological characteristics.

Method: were treated 129 children (74 boys and 55 girls, 5-17 y.o.), with different variants of WPWsyndrome with symptomatic palpitation. ECG, echocardiography, 24 hour monitoring, noninvasive and invasive electrophysiology study before the procedure were done. RFCA of the accessory pathways was performed in all patients.

Results: 15 pts (11,6%) had multiple accessory pathways (a total of 32 pathways: 13 pts had 2 and 2 pts had 3 pathways). 2 pts (13,3%) had a structural heart disease (Ebshtein anomaly). The pathways were left free wall (18 pathways), right free wall (8 pathways), posteroseptal (3 pathways), and anteroseptal (3 pathways). 11 pts had the pathways on one fibrosis annulus, and four patients on two valve. Of these 32 pathways, 31 (96,9%) were ablated successfully without complications, in 1 pt ablation was failed. 1 pt also had atrioventricular nodal reentrant tachycardia and the slow pathway area was modified. 6 pts had different atrial arrhythmia were observed during electrophysiology study – atypical atrial flutter and atrial fibrillation. The follow-up period was 3-24 month. There were 4 recurrence of tachycardia: two patients had recurrence of anteroseptal pathways, 1 pt had recurrence of 2 pathways - posteroseptal and left free wall localization and once newly pathway was found at the repeat session.

Conclusion: multiple pathways are not rare in pediatric patients and often combine with atrial arrhythmias, and in combination with anterograde accessory pathway is the the predictor of high risk sudden cardiac death.