Clinical Study on Supraventricular Tachycardia in Children

ABSTRACT

PURPOSE: Supraventricular tachycardia(SVT) is the most common symptomatic tachyarrhythmia in pediatric age group. Causes, types, and clinical characteristics of this arrhythmia in children are different from those in adults. This study was undertaken to investigate the clinical features of SVT in children. METHODS: A retrospective study was done on 36 patients with SVT, who were diagnosed at Department of Pediatrics, Chonnam National University Hospital from January, 1991 through August, 1999. The types of SVT, age of onset, associated cardiovascular abnormalities, and response to treatment were analyzed. RESULTS: Atrioventricular reentrant tachycardia(AVRT) using an accessory pathway was found in 63.9%. Primary atrial tachycardia and AV nodal reentrant tachycardia(AVNRT) were noted in 25.0% and in 5.6%, respectively. SVT occurred in over 50% of the total patients before 1 year of age : during the neonatal period, 22.2% ; during the infant period, 33.3%. Primary atrial tachycardia usually developed in the infant period. AVRT mostly occurred in the infant period, appeared to decline in the preschool period and then to increase again in the school age. AVNRT occurred only after 1 year of age. Associated cardiovascular abnormalities were found in 22.2%. Successful conversion to sinus rhythm was possible in 91.7%. Initially, normal sinus rhythm was achieved in 55.9% of the 34 children treated with adenosine. Radiofrequency catheter ablation(RFCA) was successfully performed in all 10 patients without complication and there was no recurrence of SVT during the follow-up period. CONCLUSION: We conclude that the mechanism of SVT appeared to have an age-dependent distribution, AVRT was the most common mechanism and adenosine was effective drug for restoration of normal sinus rhythm in the initial treatment of SVT. RFCA seemed to be effective and safe method for the treatment of SVT in children.