Diagnosis and Acute Management of Tachyarrhythmias in Children

Abstract

Tachyarrhythmias form a significant majority of the cardiac emergencies encountered in the pediatric age group. While the initial management often depends on the hemodynamic status of the patient at presentation, a systematic approach that follows the stabilization of the patient with the tools available at bedside, specifically the surface electrocardiogram often results in optimal treatment response that is tailored towards the mechanism and severity of the arrhythmia. The goal of this review is to provide the pediatric cardiologist with such an approach based on clinical history and analysis of the electrocardiogram (ECG). Illustrative examples are used to explain this approach towards the more common tachyarrhythmias. A general overview of the initial anti-arrhythmic interventions will be provided.

Arritmias en población pediátrica general: una revisión de la literatura

“…En relación al enfrentamiento de taquiarritmias para reconocer el ritmo especifico es recomendable distinguir si son de complejo angosto/ancho y la relación atrioventricular [17].…”

Arrhythmias Occurring in Children during HEMS Intervention: A Retrospective Cohort Study

“…Symptoms that may suggest arrhythmias are often nonspecific ailments, such as difficulty in feeding and anxiety or palpitations, heaviness in the chest, and presyncope [ 7 ]. Typical primary arrhythmias are atrial fibrillation (AF), atrial tachycardia (AT), atrioventricular nodal reentry tachycardia (AVNRT), atrioventricular re-entrant tachycardia (AVRT), bundle branch block (BBB), multifocal atrial tachycardia (MAT), permanent junctional reciprocating tachycardia (PJRT), supraventricular tachycardia (SVT), ventricular tachycardia (VT), and Wolff–Parkinson–White (WPW) [ 8 ]. The most common arrhythmias in children include sinus tachycardia, supraventricular tachycardia, bradycardia, and atrial fibrillation [ 9 ].…”

Investigation of the Effectiveness of Cortexin in the Treatment of Cardiac Arrhythmias in Children

“…Life-threatening arrhythmias in children include: long QT syndrome, paroxysmal tachycardia, high-grade ventricular extrasystole and high-grade blockades. According to Holter monitoring data, from 50 to 90% of conditionally healthy children have some kind of heart rhythm disorders [5]. In healthy children, the most common are: migration of the cardiac pacemaker (13.5%), bradycardia (3.5%), accelerated atrial rhythm (2.7%), extrasystole (1.9%), WPW phenomenon (0.5%), grade I AVB (0.5%) and prolongation of the QT interval (0,3%) [4,6].…”

“…In healthy children, the most common are: migration of the cardiac pacemaker (13.5%), bradycardia (3.5%), accelerated atrial rhythm (2.7%), extrasystole (1.9%), WPW phenomenon (0.5%), grade I AVB (0.5%) and prolongation of the QT interval (0,3%) [4,6]. At the same time, they occupy a leading place in the structure of pediatric cardiological morbidity and causes of mortality from cardiac arrhythmias (60-70%) [2,5]. These pathologies are most often based on organic heart lesions of congenital and acquired genesis [7].…”