Síncope neurocardiogénico en el paciente pediátrico / Neurocardiogenic syncope in childrens

The diagnosis of neurocardiogenic syncope in the pediatric patient is increasing in frequency. The difficulty to diagnose in the pediatric group of age is greater because of their lack of communication skills to describe the symptoms or to identify them, and thus the reason why in many cases neurologic and cardiac studies are performed to discard other pathologies, before suspecting the diagnosis of vasdvagal syncope. A thorough physical exam and the use of adequate resources for diagnosis are key factors for appropriate treatment. This is based principally in general measures and depending on the results of the head up tilt test, pharmacological treatment can be administered, even though optimal treatment is still in universal discussion.

Incidencia y comportamiento clínico de las arritmias asociadas con cardiopatía congénita y corrección quirúrgica / Incidence and clinical behavior of arrhythmias associated with congenital heart disease and surgical treatment

Congenital heart disease is associated with arrhythmias. Not only the congenital anatomic settings but also the arrhythmogenic substrate related to surgical procedures is associated with the increased incidence of arrhythmias in these patients. In the National Institute of Cardiology, we reviewed retrospectively 128 clinical records of patients subjeted to surgical treatment of congenital heart disease (81 Fontan surgery, 19 with anomalous pulmonary drainage, 19 Fallot tetralogy). The incidence of supraventricular tachycardia was 8.6%, and the bradyarrhythmias were 15% with AV block in different degrees. Permanent pacing was required in 7.8% of the patients. The incidence of arrhythmias in post-surgical patients with congenital heart disease is increasing constantly.