PAROXYSMAL TACHYCARDIA IN INFANCY AND CHILDHOOD II. Paroxysmal Ventricular Tachycardia and Fibrillation |
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Authors: | J. VIDEBÅ EK,ELLEN DAMGÅ RRD ANDERSEN,J. RAMSØ SE IACOBSEN,E. SANDØ SE,A. WENNEVOLD |
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Affiliation: | Departments of Cardiology and Pafdiatrics, Årlius Kommunehospital, Århus. Mcdical Department B and Department of Paediatrics C, Rigshospitalet, Copenhagen, and Queen Louise's Childrens' Hospital, Copenhagen, Denniark |
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Abstract: | A retrospective 3–20-years follow-up study of 1 infant and 10 children with paroxysmal ventricular tachycardia (8 cases) or fibrillation (3 cases) is presented. Additional heart disease has been observed in 60% (myocarditis 3 cases, cardiomyopathy 3 cases, congenital heart disease 1 case). Symptoms of tachycardia were: palpitation, tiredness, weakness, dyspnoea, precordial and abdominal pain. Syncopes were observed in 3 cases; 1 child had no symptoms. Tachycardia of hours to days' duration have been noted in 8 patients, 7 had tachycardia of repetitive type with a-v dissociation, one continuous tachycardia without any intervening sinus beats after the onset of tachycardia and with retrograde atrial activation. The remaining 3 children had brief malignant tachycardia, i.e. stress-provoked bursts of ventricular activity occasionally converting to ventricular fibrillation causing syncope. The diagnosis of brief malignant tachycardia had to be based on exercise ECG (2 cases) or long-term ECG-monitoring by telemetry (one case). One child with cardiomyopathy had died at the time of follow-up and the 3 patients with brief malignant tachycardia had experienced repeated life-threatening attacks—one of which had to be stopped by emergency d.c. countershock. The period of attacks ceased in 5 cases within 2 years after onset, in 1 patient, 9 years elapsed between first and second attack. Preventive treatment with betablocking agents proved beneficial in the 3 children with brief malignant tachycardia. |
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Keywords: | Paroxysmal tachycardia ventricular tachycardia fibrillation infants children |
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