Follow-up of children or teenagers with paroxysmal supraventricular tachycardia, but without pre-excitation syndrome

Autor: Julie A. Vincent, Béatrice Brembilla-Perrot, Vladimir Manenti, J.P. Lethor, Anne Moulin-Zinsch, Thibaut Villemin, Sellal Jean Marc, Arnaud Olivier, François Marçon, Anne Tisserant
Rok vydání: 2016
Předmět:
Tachycardia
Male
medicine.medical_specialty
Time Factors
Adolescent
medicine.medical_treatment
Accessory pathway
030204 cardiovascular system & hematology
03 medical and health sciences
Electrocardiography
0302 clinical medicine
Recurrence
Risk Factors
Internal medicine
medicine
Odds Ratio
Tachycardia
Supraventricular
Humans
Tachycardia
Atrioventricular Nodal Reentry
Sinus rhythm
General anaesthesia
030212 general & internal medicine
Child
Tachycardia
Paroxysmal
Retrospective Studies
Chi-Square Distribution
business.industry
Age Factors
General Medicine
Ablation
medicine.disease
Atrioventricular reentrant tachycardia
Accessory Atrioventricular Bundle
Logistic Models
Treatment Outcome
Multivariate Analysis
cardiovascular system
Cardiology
Catheter Ablation
Female
Supraventricular tachycardia
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Electrophysiologic Techniques
Cardiac
Pre-excitation syndrome
Follow-Up Studies
Zdroj: Archives of cardiovascular diseases. 110(11)
ISSN: 1875-2128
Popis: Paroxysmal supraventricular tachycardia (SVT) is considered benign in children if the electrocardiogram in sinus rhythm is normal, but causes anxiety in parents, children and doctors.To report on the clinical and electrophysiological data from children with SVT, their follow-up and management.Overall, 188 children/teenagers (mean age 15±2.8 years) with a normal electrocardiogram in sinus rhythm were studied for SVT, and followed for 2.3±4 years.SVT was poorly tolerated in 30/188 children (16.0%). SVT was related to atrioventricular nodal reentrant tachycardia (AVNRT) (n=133) or atrioventricular reentrant tachycardia (AVRT) over a concealed accessory pathway (n=55; 29.3%). Ablation of the slow pathway (n=66) or the accessory pathway (n=43) was performed without general anaesthesia, 2±3 years after initial evaluation. Failure or refusal to continue occurred in 18/109 (16.5%) children: 7/66 with AVNRT (10.6%), 11/43 with AVRT (25.6%) (P0.001). Symptoms of SVT recurred in 20/91 children (22.0%) with apparently successful ablation: 6/91 (6.6%) had real SVT recurrence; 14/91 (15.4%) had only a sinus tachycardia, more frequent in AVNRT (11/59; 18.6%) than AVRT (3/32; 9.4%) (P0.05). In 13 children treated with an antiarrhythmic drug (AAD), SVT recurred in four; two presented AAD-related syncope. In 66 untreated children, one death was noted after excessive AAD infusion to stop SVT; the others remained asymptomatic or had well-tolerated SVT.At the time of ablation, SVT management remains difficult in children. Indications for ablation are more common in AVRT than in AVNRT, but failures are frequent; 22.0% remained symptomatic after successful ablation, but false recurrences were frequent (15.4%). Without ablation, one third had a spontaneous favourable evolution.
Databáze: OpenAIRE
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