Ghiorghiu Ioana, Ciudin R, Serban Marilena, Popescu B A, Ginghină Carmen
Prof. Dr. C. C. Iliescu Institute of Cardiovascular Diseases, Bucharest, Romania.
Rom J Intern Med. 2004;42(3):575-83.
Persistent disturbances of rhythm with high heart rate may lead to reversible depression of left ventricular function and biventricular failure. This phenomenon may appear also in children with incessant supraventricular tachycardia. Because in most cases these patients are long time asymptomatic the diagnosis of these arrhythmias is very difficult and frequently is belated. In case of correct treatment of the arrhythmia, the cardiac function improves rapidly.
To present a number of cases of incessant supraventricular tachycardia in children, which has led to tachyarrhythmic cardiomyopathy and heart failure.
A number of six patients (pts.), aged between 3 years 10 m - 16 y, hospitalized between January 1st, 2001 - January 1st , 2004 were taken in study. All patients had long crisis of supraventricular tachycardia with incessant character. A clinical exam, an ECG, a chest X-ray film and an echocardiography were made to all patients. An electrophysiologic study was made in two cases. The emergency therapy was the drug therapy.
At the moment of hospitalization all patients had a depression of the contractile function of the myocardium. After the control of the arrhythmia the ejection fraction recovered in a period between 3 months and one year.
The disturbances of rhythm may induce a depression of the contractile function of the myocardium, which is reversible in many cases. The correct antiarrhythmic treatment led to the improvement of the heart failure in this case.
持续性心律紊乱伴心率加快可能导致左心室功能可逆性减退及双心室衰竭。这种现象也可能出现在持续性室上性心动过速的儿童中。由于在大多数情况下这些患者长期无症状,这些心律失常的诊断非常困难且常常延迟。如果对心律失常进行正确治疗,心脏功能会迅速改善。
介绍一些儿童持续性室上性心动过速病例,这些病例已导致快速心律失常性心肌病和心力衰竭。
选取2001年1月1日至2004年1月1日期间住院的6例患者,年龄在3岁10个月至16岁之间。所有患者均有持续性室上性心动过速的长期发作。对所有患者进行了临床检查、心电图、胸部X光片和超声心动图检查。对2例患者进行了电生理研究。紧急治疗为药物治疗。
住院时所有患者均有心肌收缩功能减退。心律失常得到控制后,射血分数在3个月至1年的时间内恢复。
心律紊乱可能导致心肌收缩功能减退,在许多情况下这是可逆的。在这种情况下,正确的抗心律失常治疗可使心力衰竭得到改善。