Eur J Pediatr. 2025 Jul 9;184(8):475. doi: 10.1007/s00431-025-06290-7.ABSTRACTThis study aimed to evaluate physical activity levels and identify factors influencing physical activity in paediatric Wolff-Parkinson-White (WPW) syndrome patients. The clinical characteristics, arterial stiffness assessed using a non-invasive oscillometric method, and cardiorespiratory fitness measured through cardiopulmonary exercise test were recorded. Physical activity levels using Physical Activity Questionnaire for Older Children (PAQ-C), outcome expectations, perceptions of family support, as well as the barriers reported by participants' parents, were evaluated using standardized questionnaires. Twenty-six paediatric WPW patients (11.12 years, 7 female) and 19 controls (12.31 years, 6 female) were included, with similar age, gender, and body composition (p > 0.05). Peak oxygen uptake (VO₂peak), peak heart rate (HRpeak), and HR reserve (HRR) were significantly lower in the WPW group compared to controls (p < 0.05). Pulse wave velocity (PWV) was similar between both groups. Although patients tended to have lower PAQ-C scores compared to their controls (p = 0.097), scores for negative and positive physical activity outcome expectancies, perceived home support for physical activity (Physical Activity Home Environment), and parents' perceived barriers to physical activity including both environmental and personal domains (Physical Activity Barriers) were similar between groups (p > 0.05). In WPW patients, PAQ-C scores correlated positively with VO₂peak (r = 0.495; p = 0.010) and negatively with PWV (r = -0.453; p = 0.020). While paediatric WPW patients and their healthy peers show similar physical activity levels, expectations, family support, and parental barriers, their lower cardiorespiratory fitness may increase the risk of reduced physical activity. These findings suggest a link between habitual physical activity, exercise capacity, and vascular health, emphasizing the complex interplay of physiological and psychosocial determinants of physical activity in WPW.Trial registration: NCT06349109 (2024-03-30 What is Known: • Children with heart disease generally exhibit lower physical activity levels compared to their healthy peers. • Both physiological and psychosocial factors are known to influence physical activity levels in children with heart disease. What is New: • Physical activity levels, outcome expectancies, family support, and perceived parental barriers were similar between pediatric WPW patients and healthy controls. • Lower exercise capacity and altered vascular health parameters may contribute to a higher risk of reduced physical activity in children with WPW syndrome. • These findings highlight the importance of addressing both physiological and psychosocial factors when promoting physical activity in pediatric WPW patients.PMID:40634817 | DOI:10.1007/s00431-025-06290-7