Background: In contrast to adults, in whom cardiac rhythm disorders are mainly conditioned by coronary artery disease, in children, arrhythmias are most often associated with inherited heart disorders. Catheter ablation (CA) has an important role in the management of cardiac arrhythmias, in adults and children. The aim of the study was to assess and compare the efficacy and safety of CA in children and adults with preexcitation syndrome. Methods: The study population comprised 43 adults and 43 children diagnosed with a Wolff-Parkinson--White syndrome (WPW). The mean age of the study population was 41 ± 15 years for adults and 14 ± 2.5 years for children. In all patients, an electrophysiological study and CA were performed. Analysis with respect to the procedure duration, fluoroscopy exposure time, location of accessory pathways (AP), immediate success rate and complications were performed. Results: Electrophysiological study revealed the most frequent presence of left-sided AP (56% in children and 70% in adults). The mean procedure duration was 96 ± 36 min and 106 ± 51 min in children and adults, respectively (p = NS). The mean fluoroscopy duration was 8.5 ± 4.3 min and 5.9 ± 5.8 min in children and adults, respectively p < 0.05. The CA procedure was successful in 40 out of 43 (93%) adults and in 36 out of 43 (83.7%) children (p = NS). In 2 (4%) children minor complications occurred. Conclusions: Ablation in children and adults are equally effective with respect to short-term clinical observation.
Premature ventricular contractions (PVC) are frequently seen in children. We evaluated left ventricular diastolic function in PVC children with normal left ventricular systolic function to detect whether diastolic function disturbances affect physical performance. The study group consisted of 36 PVC children, and the control group comprised 33 healthy volunteers. Echocardiographic diastolic function parameters such as left atrial volume index (LAVI), left atrial strains (AC-R, AC-CT, AC-CD), E wave, E deceleration time (Edt), E/E’ ratio, and isovolumic relaxation time (IVRT) were measured. In the cardiopulmonary exercise test (CPET), oxygen uptake (VO2 max) was registered. Evaluation of diastolic function parameters revealed statically significant differences between the patients and controls regarding Edt (176.58 ± 54.8 ms vs. 136.94 ± 27.8 ms, p < 0.01), E/E’ (12.6 ± 3.0 vs. 6.7 ± 1.0, p < 0.01), and IVRT (96.6 ± 19.09 ms. vs. 72.86 ± 13.67 ms, p < 0.01). Left atrial function was impaired in the study group compared to controls: LAVI (25.3 ± 8.2 ml/m2 vs. 19.2 ± 7.5 ml/m2, p < 0.01), AC-CT (34.8 ± 8.6% vs. 44.8 ± 11.8%, p < 0.01), and AC-R-(6.0 ± 4.9% vs. −11.5 ± 3.5%, p < 0.01), respectively. VO2 max in the study group reached 33.1 ± 6.2 ml/min/kg. A statistically significant, moderate, negative correlation between VO2 max and E/E’ (r = −0.33, p = 0.02) was found. Left ventricular diastolic function is impaired and deteriorates with the arrhythmia burden increase in PVC children. Ventricular arrhythmia in young individuals may be related to the filling pressure elevation and drive to exercise capacity deterioration.
Premature ventricular contractions(PVCs) are frequently seen in children. The diastolic function has not been investigated in PVC children. We evaluated the left ventricular diastolic function in PVC children with normal left ventricular systolic function to detect whether potential diastolic function disturbances influence physical performance. In the study group (36 PVCs children) and the controls (33 healthy volunteers). Echocardiographical diastolic function parameters such as left atrial volume index(LAVI), left atrial strains (AC-R, AC-CT, AC-CD), E wave, E’ medial atrial tissue doppler velocity, E/E’ and isovolumic relaxation time (IVRT) were measured. In the CPET, oxygen uptake (VO2max) was registered. Evaluation of diastolic function parameters revealed statically significant differences between the study and control group regarding Edt 176.58 ± 54.8ms vs 136.94 ± 27.8ms,p < 0.01; E/E’12.6 ± 3.0 vs. 6.7 ± 1.0,p < 0.01; IVRT 96.6 ± 19.09ms. vs. 72.86 ± 13.67 ms,p < 0.01, respectively. Left atrial function was impaired in the study group compared to controls: LAVI 25.3 ± 8.2ml/m2 vs. 19.2 ± 7.5ml/m2,p < 0.01, AC-CT 34.8 ± 8.6% vs. 44.8 ± 11.8%,p < 0.01; AC-R-6.0 ± 4.9% vs. -11.5 ± 3.5%, p < 0.01, respectively. Statistically significant moderate, negative correlation between VO2max and E/E’(r =-0.33, p = 0.02) was found. Left ventricular diastolic function is impaired and deteriorates with the arrhythmia burden increase in PVC children. Ventricular arrhythmia in young individuals may be related to the filling pressure elevation and drive to exercise capacity deterioration.
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