Müller G I, Ulmer H E, Bauer J A
Department of Paediatric Cardiology, Children's Hospital, University of Giessen, Federal Republic of Germany.
Eur J Pediatr. 1992 Jan;151(1):12-4. doi: 10.1007/BF02073881.
We report on two cases of mechanical termination of supraventricular tachycardia by chest thump which were followed by serious complications. In a 3-year-old boy with an otherwise normal heart, incessant supraventricular tachycardia was converted to sinus rhythm by a single precordial thump. This, however was followed by thrombo-embolic infarction of the left-sided middle cerebral artery. In another case of a 9-year-old girl, recurrent episodes of supraventricular tachycardia were associated with Ebstein anomaly of the tricuspid valve. Chest thump was successful in terminating supraventricular tachycardia but induced a short run of ventricular tachycardia which terminated itself and was then followed by sinus rhythm. It is concluded that even a slight precordial thump implies undetermined risks in the acute management of supraventricular tachycardia in children and should therefore be abandoned in favour of other methods.
我们报告两例通过胸部捶击机械性终止室上性心动过速后出现严重并发症的病例。在一名心脏其他方面正常的3岁男孩中，持续性室上性心动过速通过单次心前区捶击转为窦性心律。然而，随后发生了左侧大脑中动脉的血栓栓塞性梗死。在另一例9岁女孩中，室上性心动过速反复发作与三尖瓣埃布斯坦畸形有关。胸部捶击成功终止了室上性心动过速，但诱发了一阵短暂的室性心动过速，该室性心动过速自行终止，随后转为窦性心律。结论是，即使是轻微的心前区捶击在儿童室上性心动过速的急性处理中也意味着不确定的风险，因此应放弃这种方法而采用其他方法。
