ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Pediatric Cardiac Arrhythmias
Dr. Aygün DİNDARa
aPediatrik Kardiyoloji BD, İstanbul Üniversitesi İstanbul Tıp Fakültesi, İSTANBUL
Arrhythmias in children can be either recognized as irregular heart beat, during routine examinations or patients may present with various symptoms such as chest pain, palpitations, dizziness and syncope.
Sinus arrhythmia, wandering atrial rhythm, premature atrial and ventricular beats and nodal rhythm are bening arrhythmias and relatively common among healthy children. No furhther investigations and follow up are usually necessary.
The incidence of supraventricular tachycardia (SVT) in children range from 1 in 250 to 1 in 1000, compresing approximately 95% of arrhythmias in children with structurally normal hearts. There are three age categories in which the incidence of symptomatic SVT episode increase: 1) the neonatal period; 2) middle chilhood; and 3) adolescence. Ninety percent of pediatric SVT, are due to a reentrant mechanism that includes the AV node as AV reentry tachycardia (AVRT) and AV nodal reentry tachycardia (AVNRT). In the remaining 10 % of SVT, the AV node is not a part of the arrhythmia circuit. Atrial flutter, atrial fibrillation, atrial ectopic tachycardia are the reentrant tachycardias involved in this group.
Ventricular arrhythmias are less common in children. Long QT syndrome and Brugada syndrome are primary electrical diseases which can occur in anatomically normal hearts. Viral myocarditis, cardiac tumours, arrhythmogenic right ventricular dysplasia, cardiomyopathies and postoperative congenital heart disease are structural heart diseases which may be associated with ventricular arrhythmias. Hypertrophic cardiomyopathy, Kawasaki disease and congenital coronary abnormalities may cause to ischemia-induced ventricular arrhythmias.
Conduction disorders consist of a relatively less common group of childhood arrhythmias, mostly due to atrioventricular blocks and sinus node dysfunction following surgery for congenital heart disease. The second group in this category is congenital heart blocks.
In this article, the diagnostic approach and management strategies of pediatric arrhythmias are reviewed.Keywords: Child, arrhythmia, supraventricular tachycardia,
ventricular tachycardia, AV blockTurkiye Klinikleri J Int Med Sci 2005, 1(15):123-134
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