Wolff-Parkinson-White syndrome and isoproterenol testing in children: a valid adjunct to predict risk?

Wolff-Parkinson-White syndrome (WPW) is the most common indication for invasive cardiac catheterization and electrophysiological testing in children. There are presently 2 predominant reasons for this. First, patients with WPW are, as the original 1930 investigators so eloquently pointed out, at risk for “paroxysmal tachycardia.”1 Supraventricular tachycardia is typically either orthodromic or, less commonly, antidromic reentrant tachycardia and can cause recurrent and debilitating symptoms. Present-day ablation techniques provide the promise of a cure for WPW in as many as 90% to 100% of patients who undergo this procedure with relatively low risk.2,3 Multiple studies have demonstrated the many medical, psychological, and financial benefits of ablation in the symptomatic WPW child.4–6