ABSTRACT
Objective To explore the relationship of etiopathogenesis,therapy and prognosis in children with chronic arrhythmia.Met-hods Forty cases aged 48 h to 12 years old between Sep.2003 to Oct.2006 were selected.All children had vertigo,syncope,Adam-Stoke syndrome,cardiac shock.Some cases were detected with complete atrioventricular block(CAVB)(33 cases),sinus bradycardia(5 cases) or sick sinus syndrome(2 cases) by electrocardiogram(ECG) at least 2 times,and these symptoms lasted 3 days at least.Congenital CAVB children having no clinical symptom were given no treatment.Cases having sinus bradycardia,sick sinus syndrome resulted from viral myocarditis,the earlier were given antiviral medicine,energy composition,intravenous megavitamin C,isoprenaline,and large dose of adrenocortcal hormone simultaneously.Some were given human ?-globulin.Eight of them were set temporary pacemaker because of unsatisfactory treatment,and 2 of them were set permanent pacemaker.Results Twenty-eight cases were cured,9 cases were improved and 3 cases died.Six out of the cured cases and improved cased were set permanent or temporary pacemaker.Conclusions Early discovery,early diagnosis,and early temporary pacemaker use will lead a better prognosis in regular treatment.On the contrary,the delayed treatment on children with viral myocarditis and CAVB caused by dilated cardiomyopathy will lead a negative prognosis.
ABSTRACT
Objective To explore the value of temporary cardiac pacemaker therapy on children with Adam-Stoke syndrome(ASS).Methods Nine children with ASS was implanted the emporary cardiac pacemaker under X-ray or blinding inserted beside bed.Results Seven children was successfully implanted the temporary cardiac pacemaker within 1-2 d of ASS attack,and two children was successfully implanted at 10 d and 20 d after ASS attack, respectively. Five patients was cured, two children was died, and two children was implanted the permanent cardiac pacemaker. During pacing, two patients had the electrode shifted,and one patient had the cardiac murmur,and one patient had the local skin infected.Conclusion Temporary cardiac pacemaker can successfully treat children with ASS attack;the earlier the implantation,the better the prognosis.
ABSTRACT
Objective To explore the prognosis and etiological treatment of cardiogenic syncope in children.Methods The cause,clinical manifestation,treatment and prognosis of 45 children with syncope were made in affiliated hospital of Qingdao medical university were su mmarized and analyzed.They were divided into arhythmia group and other groups,the former included myocarditis,dilated cardiomyopathy,and post-operation of congenital heart disease and the latter included tetralogy of fallot,pulmonary stenosis,hypertrophic cardiomyopathy,pericarclial effusion,and right atrial myxoma.Results There were 29 cases(64.44%) with arrhythmia in this group,of which there were 18 cases with complete atrioventricular block(CAVB),2 cases with second degree type Ⅱ atrioventricular block,3 cases with ventricular tachycardia,2 cases with bradycardia,2 cases with atrial flutter,1 case with supraventricular tachycardia,and 1 case with nonconducting atrial premature.There were 16 cases(35.56%) with other etiologies,of which there 8 cases with tetralogy of Fallot,2 cases with pulmonary stenosis,hypertrop-hic cardiomyopathy,pericardial effusion,and right atrial myxoma,respectively.Children with CAVB,bradycardia,or ventricular tachycardia resulted from viral myocarditis were given anti-virus medicine,protecting myocardium,neoepinephrine,and intravenous vitamin C 100-200 mg/(kg?d).Dexamethasone 1-2 mg/(kg?d) was given in earlier period for short course,and some children were given human ?-globulin.Eight cases were placed temporary pacemaker because of unsatisfactory therapeutic efficacy,and 1 case was placed permanent pacemaker.In all,38 cases(84.44%)were cured,1 case(2.22%)was improved,and 4 cases(8.88%) died.Conclusions Cardiogenic syncope is pediatric emergency and shall be treated immediately.Temporary pacemaker shall be placed at the right moment.