Bjelakovic Bojko, Vukomanovic Goran, Vukomanovic Vladislav, Pejcic Ljiljana, Saranac Ljiljana, Bjelakovic Ljiljana, Dimitrijevic Lidija
Clinic of Pediatrics, Clinical Center Nis, Zorana Djindjica 48 Boulevard, 18000, Nis, Serbia.
Clin Auton Res. 2007 Jun;17(3):153-9. doi: 10.1007/s10286-007-0416-1. Epub 2007 May 25.
Idiopathic ventricular tachycardia (IVT) is a rare arrhythmia in children. A great deal of uncertainty and numerous questions still remain regarding the extent of investigation, therapy, and long-term prognosis for children with IVT. The existence of subclinical cardiac disease, as well as of autonomic dysfunction in patients with ventricular arrhythmias, has been well documented. A number of experimental and clinical studies have suggested that imbalances within the cardiac autonomic system's activity may be crucial in the generation of ventricular tachycardia, irrespective of the presence of cardiovascular pathological substrate. Heart rate variability (HRV) analysis provides a useful method for measuring the autonomic activity. This study evaluates HRV in children with IVT. The study included 31 children with ventricular arrhythmia who were divided into two groups: (1) patients with frequent ventricular extrasystoles (VES) and (2) patients with IVT. The control group comprised 23 healthy children without pathological findings on 24-h ECG Holter. Twenty-four-hour ambulatory electrocardiography recordings were obtained, and the time-domain variables were calculated. HRV was compared to age-related normal values. It was observed that the overall heart rate variability is diminished in children with IVT. We recommend HRV analysis of any child with IVT. Quantification of the autonomic nervous system activity using time domain analyses may be a helpful diagnostic tool in the clinical assessment and initial evaluation of these children.
特发性室性心动过速(IVT)在儿童中是一种罕见的心律失常。关于IVT患儿的检查范围、治疗方法和长期预后,仍存在大量不确定性和诸多问题。室性心律失常患者存在亚临床心脏病以及自主神经功能障碍,这一点已有充分记录。许多实验和临床研究表明,无论是否存在心血管病理基础,心脏自主神经系统活动的失衡可能在室性心动过速的发生中起关键作用。心率变异性(HRV)分析为测量自主神经活动提供了一种有用的方法。本研究评估了IVT患儿的HRV。该研究纳入了31例室性心律失常患儿,分为两组:(1)频发室性早搏(VES)患者和(2)IVT患者。对照组包括23名24小时动态心电图Holter检查无病理发现的健康儿童。获取了24小时动态心电图记录,并计算了时域变量。将HRV与年龄相关的正常值进行比较。观察到IVT患儿的整体心率变异性降低。我们建议对任何IVT患儿进行HRV分析。使用时域分析对自主神经系统活动进行量化,可能是这些患儿临床评估和初步评价中的一种有用诊断工具。