September 16, 2004
Starkweather, B.S. and Asher Kimchi M.D.
Ventricular fibrillation can be the presenting arrhythmia in
children with asymptomatic Wolff-Parkinson-White syndrome.
However, deaths due to this arrhythmia are potentially
A study by Carlo
Pappone, M.D., at San Raffaele University in Milan, Italy,
published in the September 16, 2004 issue of the New England
Journal of Medicine compared the occurrence of arrhythmic
events in children with Wolff-Parkinson-White syndrome treated
with prophylactic radiofrequency catheter ablation to those
with no ablation treatment.
A randomized study of forty-seven asymptomatic children
between the ages of five and twelve with Wolff-Parkinson-White
syndrome, determined to be at high risk for arrhythmia, was
performed to compare the incidence of arrhythmia in children
treated with prophylactic ablation compared to those who were
not treated. During following up, only five percent of the
treatment group had arrhythmic events, while forty-four
percent of the control group had such events. This reduction
in arrhythmia risk is significant.
This study points to the value of prophylactic radiofrequency
catheter ablation therapy in asymptomatic, high-risk children
with Wolff-Parkinson-White syndrome in order to prevent
arrhythmic events and death due to ventricular fibrillation.