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Follow-up of children or teenagers with paroxysmal supraventricular tachycardia, but without pre-excitation syndrome.
- Source :
-
Archives of cardiovascular diseases [Arch Cardiovasc Dis] 2017 Nov; Vol. 110 (11), pp. 599-606. Date of Electronic Publication: 2017 Jul 24. - Publication Year :
- 2017
-
Abstract
- Background: 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.<br />Aims: To report on the clinical and electrophysiological data from children with SVT, their follow-up and management.<br />Methods: 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.<br />Results: 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%) (P<0.001). 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%) (P<0.05). 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.<br />Conclusions: 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.<br /> (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Adolescent
Age Factors
Chi-Square Distribution
Child
Electrocardiography
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Humans
Logistic Models
Male
Multivariate Analysis
Odds Ratio
Recurrence
Retrospective Studies
Risk Factors
Tachycardia, Atrioventricular Nodal Reentry diagnosis
Tachycardia, Atrioventricular Nodal Reentry physiopathology
Tachycardia, Paroxysmal diagnosis
Tachycardia, Paroxysmal physiopathology
Tachycardia, Supraventricular diagnosis
Tachycardia, Supraventricular physiopathology
Time Factors
Treatment Outcome
Accessory Atrioventricular Bundle
Catheter Ablation adverse effects
Tachycardia, Atrioventricular Nodal Reentry surgery
Tachycardia, Paroxysmal surgery
Tachycardia, Supraventricular surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1875-2128
- Volume :
- 110
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Archives of cardiovascular diseases
- Publication Type :
- Academic Journal
- Accession number :
- 28751003
- Full Text :
- https://doi.org/10.1016/j.acvd.2017.01.013