{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:30:31Z","timestamp":1787729431314,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,9,11]],"date-time":"2015-09-11T00:00:00Z","timestamp":1441929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Intermittent Wolff\u2010Parkinson\u2010White (WPW) syndrome is considered to have a lower risk of sudden death. Fewer data exist regarding electrophysiologic (EP) characteristics and the natural history of intermittent WPW in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with WPW age 1\u201318 years at a single institution (1996\u20132013) were reviewed. Patients with intermittent preexcitation were compared to those with loss of preexcitation on Holter\/exercise testing and those with persistent preexcitation. High\u2010risk accessory pathway (AP) was defined as AP effective refractory period (APERP), block cycle length, or shortest preexcited RR interval during atrial fibrillation \u2264250 ms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 295 patients were included: 226 (76.6%) persistent, 39 (13.2%) intermittent, and 30 (10.2%) loss of preexcitation Holter\/exercise. There were no differences in symptoms between groups. Median interquartile range APERP was significantly longer in intermittent WPW (380 [320, 488] ms vs 320 [300, 350] ms persistent, 310 [290, 330] ms loss of preexcitation Holter\/exercise; P = 0.0008). At baseline, there was no difference between groups in frequency of high\u2010risk pathways. However, when isoproterenol values were included, high\u2010risk pathways were more frequent among patients with loss of preexcitation on Holter\/exercise (54% vs 16% persistent, 11% intermittent; P = 0.005). There was one death in a patient with loss of preexcitation on exercise testing, no EP study, and prior drug use. A second patient with persistent WPW and APERP 270 ms required resuscitation following a methadone overdose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Intermittent preexcitation in children does not connote a lower risk AP by EP criteria or reduced symptoms. The low number of pediatric WPW patients who develop preexcited atrial fibrillation or sudden death warrants larger studies to investigate these outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.12732","type":"journal-article","created":{"date-parts":[[2015,8,8]],"date-time":"2015-08-08T13:02:40Z","timestamp":1439038960000},"page":"14-20","source":"Crossref","is-referenced-by-count":50,"title":["Intermittent versus Persistent Wolff\u2010Parkinson\u2010White Syndrome in Children: Electrophysiologic Properties and Clinical Outcomes"],"prefix":"10.1111","volume":"39","author":[{"given":"MICHELLE E.","family":"KIGER","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Colorado  Denver Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ANTHONY C.","family":"MCCANTA","sequence":"additional","affiliation":[{"name":"Division of Cardiology Children's Hospital Colorado  Aurora 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