[Supraventricular tachycardia in infants and children]. / Taquicardia paroxística supraventricular en el niño y el lactante.

INTRODUCTION: Supraventricular tachycardia (SVT) is the second most frequent form of arrhythmia in pediatrics after extrasystole. OBJECTIVES: 1. To determine the clinical characteristics and treatment of SVT in infants and children. 2. To determine treatment response and the drugs used. METHOD: A retrospective review of 61 cases of SVT requiring PICU admission (1999-2004) was performed. PICU admission was due to persistent SVT after vagal maneuvers. RESULTS: There were 61 patients and 39 were boys (63.9%). The mean age was 2.1 years (SD +/- 3.1). Twelve patients had congenital heart disease (19.7%); three (4.9%) were admitted after heart surgery, and the remaining patients had no antecedents (60.7%). The mean cardiac frequency was 238 beats/min (SD +/- 42.86). Heart failure (HF) was observed in 14 patients (23%). Statistically significant differences were found between the presence of HF and time since onset (p < 0.01) and younger age (p < 0.01). The most frequent diagnosis was SVT due to re-entry in 28 patients (45.9%). Medical treatment was required in 46 patients (75.4%) and response was achieved in 35 (57.4%). At crisis the first drug used was adenosine triphosphate (ATP) in 35 patients (61.4%) with good response in 21 (36.8%). As maintenance therapy digoxin was used in 29 patients (50.9%) without relapses in 22 (78.6%). Radiofrequency ablation was required in 17 patients (27.9%), and there were three relapses (17.6%). The ages of patients who underwent ablation ranged from 3.5 days to 13 years. CONCLUSIONS: 1. HF was observed mainly in infants. 2. Most of the patients had good response to ATP therapy. 3. Radiofrequency ablation was mainly required in patients aged more than 1 year.

Taquicardia paroxística supraventricular en el niño y el lactante / Supraventricular tachycardia in infants and children

Introducción La taquicardia paroxística supraventricular (TPSV) es la arritmia más frecuente en pediatría por detrás de las extrasístoles. Objetivos 1. Determinar las características clínicas y el tratamiento. 2. Objetivar la respuesta al tratamiento y los fármacos utilizados. Método Estudio retrospectivo de 61 casos con ingreso en la unidad de cuidados intensivos pediátrica (UCIP) de 1999 a 2004. Criterio de ingreso: TPSV sin respuesta a maniobras vagales. Resultados Se seleccionaron 61 pacientes, 39 varones (63,9 %). Edad media: 2,1 años (DE ± 3,1). Doce tuvieron antecedentes de cardiopatía congénita (19,7 %); tres (4,9 %) ingresaron poscirugía cardíaca; y los restantes sin antecedentes (60,7 %). La frecuencia cardíaca media fue de 238 lat./min (DE ± 42,86). Catorce pacientes (23 %) presentaron insuficiencia cardíaca (IC). Existieron diferencias estadísticamente significativas entre la presencia de IC y las horas de evolución (p < 0,01) y con la menor edad (p < 0,01). El diagnóstico más frecuente fue TPSV por reentrada (28 casos 45,9 %). Precisaron tratamiento médico 46 pacientes (75,4 %), 35 respondieron (57,4 %). Para tratar la crisis aguda se utilizó trifosfato de adenosina (ATP) en 35 casos (76 %) con buena respuesta en 21 (60 %). Para el mantenimiento se indicó digital en 29 casos (50,9 %), sin recaídas 22 casos (78,6 %). Necesitaron ablación 17 pacientes (27,9 %); recayeron tres (17,6 %). El rango de edades en los que se realizó la ablación fue de 3,5 días hasta 13 años. Conclusiones 1. La insuficiencia cardíaca se presentó preferentemente en lactantes. 2. La mayoría de pacientes respondieron al tratamiento con ATP. 3. La ablación fue necesaria preferentemente en pacientes de edad superior a un año

Introduction Supraventricular tachycardia (SVT) is the second most frequent form of arrhythmia in pediatrics after extrasystole. Objectives 1. To determine the clinical characteristics and treatment of SVT in infants and children. 2. To determine treatment response and the drugs used. Method A retrospective review of 61 cases of SVT requiring PICU admission (1999-2004) was performed. PICU admission was due to persistent SVT after vagal maneuvers. Results There were 61 patients and 39 were boys (63.9 %). The mean age was 2.1 years (SD ± 3.1). Twelve patients had congenital heart disease (19.7 %); three (4.9 %) were admitted after heart surgery, and the remaining patients had no antecedents (60.7 %). The mean cardiac frequency was 238 beats/min (SD ± 42.86). Heart failure (HF) was observed in 14 patients (23 %). Statistically significant differences were found between the presence of HF and time since onset (p < 0.01) and younger age (p < 0.01). The most frequent diagnosis was SVT due to re-entry in 28 patients (45.9 %). Medical treatment was required in 46 patients (75.4 %) and response was achieved in 35 (57.4 %). At crisis the first drug used was adenosine triphosphate (ATP) in 35 patients (61.4 %) with good response in 21 (36.8 %). As maintenance therapy digoxin was used in 29 patients (50.9 %) without relapses in 22 (78.6 %). Radiofrequency ablation was required in 17 patients (27.9 %), and there were three relapses (17.6 %). The ages of patients who underwent ablation ranged from 3.5 days to 13 years. Conclusions 1. HF was observed mainly in infants. 2. Most of the patients had good response to ATP therapy. 3. Radiofrequency ablation was mainly required in patients aged more than 1 year